Reimbursement Regulations of Jinan Door Rules 2023

In 2023, the medical insurance clinic for employees in Jinan will be a community health service institution as a whole, and the minimum payment standard will be 400 yuan.

1, first-class and second-class designated medical institutions, with Qifubiaozhun of 700 yuan; Three designated medical institutions, Qifubiaozhun is 1000 yuan.

2, the highest outpatient co-ordination annual maximum payment limit of 4500 yuan. The reimbursement rate of community health service institutions is 80%; One or two designated medical institutions, the reimbursement rate is 70%.

3, temporary medical treatment in different places outside the province, the reimbursement rate decreased 10 percentage point; Temporary medical treatment in different places and long-term medical treatment in different places in the province shall be reimbursed according to the medical institutions at the same level in the city.

Cash reimbursement process of employee medical insurance outpatient service;

1. After collecting relevant materials, the handling personnel of the reporting unit will submit them to the cash reimbursement window of the Municipal Social Security Bureau, and the staff will collect relevant materials.

2. After the audit and settlement, the fund management office will entrust the designated bank to transfer the reimbursement expenses to the financial area of the insured's medical insurance card or issue a bank passbook.

To sum up, residents' medical insurance clinics can be reimbursed. It is specifically stipulated that the medical expenses above 1800 yuan can be reimbursed only after the employees go to the hospital for emergency treatment, and the reimbursement ratio is 50%. For retirees under the age of 70,1.The expenses above 300 yuan can be reimbursed, and the reimbursement rate is 70%; For retirees over 70 years old, 80% of the expenses above 1300 yuan can be reimbursed.

Legal basis:

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

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.