What is the reimbursement ratio of medical insurance hospitalization for Jiangsu employees?

The proportion of hospitalization reimbursement for Jiangsu employees' medical insurance is as follows:

1, the reimbursement rate within the scope of Nanjing employee medical insurance hospitalization policy is 85%;

2. The proportion of hospitalization reimbursement for residents' medical insurance is 70% within the overall policy.

Matters needing attention in medical insurance reimbursement process:

1. Know the reimbursement ratio: Before hospitalization, you must first know the reimbursement ratio stipulated by the local medical insurance policy and whether there is a maximum payment limit;

2. Choose a designated hospital: only when you are hospitalized in a designated medical insurance hospital can the expenses be reimbursed;

3. Prepare relevant materials: all medical expense invoices, medical records, inspection reports and other relevant materials should be properly kept during hospitalization, because these are the supporting documents that must be submitted when reimbursement is made;

4. Pay attention to the time limit for reimbursement: after hospitalization, you should go to the social security agency for reimbursement within the prescribed time limit. Missing the time limit may affect reimbursement;

5. Understand the self-funded items: know in advance which medical items are not reimbursed by medical insurance, so as to make personal financial planning;

6. Consult the change of medical insurance policy: the medical insurance policy may change, and the latest medical insurance policy should be consulted in time before and after hospitalization to avoid affecting reimbursement;

7. Mastering the reimbursement process: Be familiar with the specific process of medical insurance reimbursement, including the steps of submitting materials, reviewing and settling accounts, so as to successfully complete the reimbursement.

To sum up, the reimbursement rate of medical insurance for employees in Jiangsu is 85%, and that for residents is 70%.

Legal basis:

Nanjing issued the "14th Five-Year Plan" for the development of medical security.

The Plan clearly states that the realization of medical insurance goals should be measured by hard data indicators. The reimbursement rate within the scope of the employee medical insurance outpatient co-ordination policy has reached more than 50%; The reimbursement rate within the scope of employee medical insurance hospitalization co-ordination policy remained stable at 85%; The reimbursement rate in the overall hospitalization policy of residents' medical insurance remained stable at 70%; The direct settlement rate between medical insurance fund and pharmaceutical enterprises reached 50%.