What is the proportion of reimbursement for serious illness among residents?

The proportion of residents' medical insurance is as follows:

1, 0-40,000 yuan will be reimbursed by 85%;

2, 40 thousand yuan-80 thousand yuan reimbursement 90%;

3 more than 80 thousand yuan according to 95% reimbursement. The maximum payment limit for each medical year is 6.5438 yuan +0.5 million yuan.

The reimbursement process of serious illness medical insurance is as follows:

1. During hospitalization or within the specified time after discharge, the patient goes to the local social security bureau for reimbursement with the detailed list of medical expenses, hospital medical records and diagnosis certificates issued by medical institutions and other related materials;

2, social security bureau to review the materials provided by patients, to determine whether it meets the conditions for reimbursement of serious illness insurance;

3. The Social Security Bureau will submit the audited reimbursement materials to the financial department for audit and accounting;

4, after the financial department audit bookkeeping, will meet the reimbursement conditions of medical expenses directly into the patient's bank account;

5, after receiving the reimbursement, patients should check whether it is consistent with the detailed list of medical expenses.

The sales methods of medical insurance for major diseases are as follows:

1. The insured suffers from malignant tumor, organ transplantation, acute myocardial infarction and other major diseases that meet the requirements of the insurance clauses.

2. The insured has been treated in a hospital or other medical institution;

3. The insured has paid a certain amount of medical expenses, which is in line with the deductible and reimbursement ratio agreed in the insurance contract;

4. The insured shall provide relevant medical expense invoices, receipts, inspection reports, hospitalization records and other documents that meet the requirements of the insurance company.

To sum up, in order to further improve the supplementary medical insurance for serious illness of urban and rural residents, and effectively improve the medical insurance protection for major diseases. Supplementary medical insurance for serious illness in lincang shall be implemented as a municipal overall plan and urban and rural overall plan, and shall be undertaken by commercial insurance institutions.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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.