Wuhan medical insurance co-ordination quota

According to the query of official website of Wuhan Medical Security Bureau, the overall amount of medical insurance for employees in Wuhan is as follows:

Standard of treatment. 1, Qifubiaozhun: The Qifubiaozhun for general outpatient service is set annually and accumulated in a natural year, and the insured person only undertakes it once. Qifubiaozhun for incumbents is 700 yuan, and Qifubiaozhun for retirees is 500 yuan.

2. Reimbursement ratio. Within the scope of the insured policy, the general outpatient medical expenses above the Qifubiaozhun of the basic medical co-ordination fund and below the maximum payment limit shall be borne by the co-ordination fund and individuals according to the following proportion:

(1) For the general outpatient service of the first-class medical institutions (including community health service institutions and township hospitals), the proportion of individual payment for on-the-job personnel is 20%, and the proportion of overall fund payment is 80%; The individual contribution ratio of retirees is 16%, and the overall fund payment ratio is 84%;

(2) For the general outpatient service of secondary medical institutions, the proportion of personal payment of on-the-job personnel is 40%, and the proportion of overall fund payment is 60%; Retirees pay 32%, and the overall fund pays 68%;

(3) General outpatient service of tertiary medical institutions, 50% paid by on-the-job staff and 50% paid by the overall fund; Retired individuals pay 40%, and the overall fund pays 60%;

(4) If the insured uses Class B drugs in the basic medical insurance drug list and Class B items in the medical service diagnosis and treatment project list, the individual shall pay 10% first, and the balance shall be implemented according to the above provisions.

3. Top line: The annual maximum fund payment limit of general outpatient department is 3,500 yuan for employees and 4,000 yuan for retirees. The payment limit is valid in a natural year and cannot be accumulated or transferred to others.

Medical insurance reimbursement method:

1. Drug purchase reimbursement: Cardholders can bring their ID cards and social security cards to the designated pharmacies, select the appropriate drugs, and then insert the cards at the settlement office for reimbursement.

2. Reimbursement for hospitalization: Cardholders can go to designated hospitals with their ID cards and social security cards, go through hospitalization procedures with social security cards, and then directly reimburse them with social security cards when they leave the hospital.

To sum up, the medical insurance pooling account can be inquired in the following ways: telephone inquiry, medical insurance window inquiry of designated hospitals, medical insurance pharmacies inquiry, medical insurance handling department inquiry, and website inquiry of social security bureau.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 4

Employers and individuals in People's Republic of China (PRC) pay social insurance premiums according to law, and have the right to inquire about payment records and personal rights records, and require social insurance agencies to provide social insurance consultation and other related services.

Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.

Article 5

The people's governments at or above the county level will incorporate social insurance into the national economic and social development plan.

The state raises social insurance funds through multiple channels. People's governments at or above the county level shall give necessary financial support to social insurance.

The state supports social insurance through preferential tax policies.