Proportion of reimbursement for tertiary medical insurance in Shenzhen social security

Proportion of reimbursement for tertiary medical insurance in Shenzhen social security

I. Deductible

1, hospitals below the first level: 100 yuan.

2. Level II Hospital: 200 yuan.

3. Level III hospital: 300 yuan.

Second, special medical materials (unit price 1000 yuan)

(1) 90% of the actual price is paid for domestic materials;

(2) The imported materials shall be paid at 60% of the actual price.

Third, the bed fee

The highest amount of payment is the first stall of triple room B (currently in 37 yuan).

Fourth, other concessions.

The basic medical insurance fund and the local supplementary medical insurance fund set the payment limit. The part of the basic medical expenses paid by the basic medical insurance fund according to this scheme that exceeds its payment limit shall be paid by the local supplementary medical insurance fund within its payment limit.

The basic medical expenses and local supplementary medical expenses incurred by the insured in the designated medical institutions in this Municipality exceed the payment limit of the local supplementary medical insurance fund, and the local supplementary medical insurance fund pays 50%.

Verb (abbreviation for verb) seeks medical treatment outside the city.

(1) Referral and filing have been handled: outpatient medical expenses paid by personal accounts that are not higher than the standard of medical charges in this Municipality shall be reimbursed and deducted from personal accounts.

(two) did not apply for referral, filing.

1, designated medical institutions outside Shenzhen: 90%

2. Non-designated medical institutions outside Shenzhen: 70%

3. Hospitalization expenses incurred by designated medical institutions in this city that fail to go through the referral procedures at the settlement hospital according to regulations: 90%.