How much can social security be reimbursed for illness?

How to reimburse medical treatment with social security card 1: What diseases can be reimbursed with social security card?

A: All diseases can be reimbursed by social security card, and the reimbursement of social security card is determined according to different amounts of different medical items. It has nothing to do with any disease.

How to reimburse social security card for medical treatment related question 2: How is the reimbursement amount of social security card for urban employees stipulated?

Answer: The outpatient and emergency medical expenses that meet the requirements of social security (1.1-12.31) and exceed 1800 yuan every year will be reimbursed by 50% in designated non-community medical institutions and 70% in the community. If you reimburse for the first time this year, the medical expenses incurred will be RMB 2,000 after deducting social security self-funded items and self-funded items, of which 1.800 yuan cannot reimburse, which is your personal burden. If 200 yuan is multiplied by 50% (non-community) or 70% (community), you will get 1, 000 yuan or 1, 400 yuan's reimbursement fee. Social security can reimburse you up to 20 thousand.

How to reimburse social security card for medical treatment 3: How is the amount of social security card medical reimbursement for retired employees under 70 years old stipulated?

Answer: 70% of outpatient and emergency services are paid by social security, 15% by retirement supplementary insurance, and (2000- 1300)X85% = 595 yuan.

How to reimburse the social security card for medical treatment? Question 4: How is the medical reimbursement amount of social security card stipulated for employees?

A: I was hospitalized. The first hospitalization was 1300, and later it was more than 650. Medical expenses below 30,000 yuan shall be reimbursed by 85% (level III hospital, the same below), 30,000-40,000 yuan shall be reimbursed by 90%, and more than 40,000 yuan shall be reimbursed by 95%, with a maximum payment of 70,000 yuan. If the maximum annual payment exceeds 70,000 yuan, it will be reimbursed at the rate of 70%, and the maximum annual social security payment is170,000 yuan (excluding outpatient and emergency services).

How to reimburse the social security card for medical treatment? Question 5: How is the medical reimbursement amount of social security card stipulated for employees?

Answer: If you are a retired employee, the reimbursement rate for medical expenses below 30,000 yuan is 9 1% (tertiary hospital, the same below), 94% for 30,000-40,000 yuan, and 97% for 40,000 yuan or more. The upper limit of payment is the same as that of employees. In addition, except for the extra personal burden (1300 or 650), the retirement part will be reimbursed by 50%.

Do you know how to reimburse the social security card for medical treatment? In addition to understanding how the social security card is reimbursed for medical treatment, I remind you again that the payment period of the social security card for medical insurance is at least 15 years. Only after reaching the payment period can you enjoy medical insurance after retirement. If you feel that the protection is insufficient, you can also purchase certain commercial insurance as a supplement.

Recently, a client was ill in hospital. Her company has social security medical reimbursement. Consumption at discharge 1200 1 yuan, social security reimbursement of 6400 yuan. Someone else paid for it! ! The out-of-pocket ratio is as high as 47.6%! ! Why? Didn't you say you could reimburse 80%? This puzzled her, so this friend came to me, asked for some information and explained how the medical insurance was reimbursed:

First of all, how to pay medical insurance:

Among them, the medical insurance card shows a personal account, and dozens to one hundred dollars are deposited in our medical insurance card every month. The overall fund is the account of the Social Security Bureau, which will be used when you are hospitalized or seriously ill.

Secondly, the scope of reimbursement: Take a 3A hospital as an example,10.5 million major diseases are capped, and 80% of ordinary inpatients between 2,000 yuan and 75,888 yuan can be reimbursed.

Thirdly, the out-of-pocket scope: general hospitalization expenses 12000 yuan, and it is conservatively estimated that out-of-pocket drugs are around 2000 yuan.

Therefore, of the medical expenses of12,000 yuan, 6,400 yuan was reimbursed by social security, and the remaining 5,600 yuan was paid by myself.

Then how is this 6400 yuan reimbursed? 12,000 yuan-2,000 yuan (deductible line of 3A hospitals) =10,000 yuan-2,000 yuan (self-paid medicine) = 8,000 yuan; 8000 yuan *80%=6400 yuan.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.