Qingdao outpatient co-ordination reimbursement limit

The overall reimbursement limit of outpatient service in Qingdao is 5,000 yuan per person per year. The higher the individual contribution, the higher the reimbursement ratio. The expenses exceeding the limit are paid at their own expense. Some specific diseases, such as tumors, rare diseases and serious diseases, are not subject to quota restrictions.

Qingdao medical insurance outpatient co-ordination reimbursement limit refers to the maximum amount that each insured person can obtain when reimbursing outpatient medical expenses within a certain time range. At present, the reimbursement limit of outpatient service in Qingdao is 5000 yuan per capita per year, that is, the part exceeding this limit needs to be paid at its own expense. However, according to the regulations of Qingdao Medical Insurance Bureau, the higher the medical insurance expenses paid by individuals, the higher the reimbursement ratio of outpatient expenses. For example, the monthly payment of employees is higher than the standard set by the Social Security Bureau, and they can enjoy a higher reimbursement rate when reimbursing outpatient expenses. It should be noted that certain diseases, such as tumors, rare diseases and serious diseases, are not limited by the reimbursement quota of Qingdao outpatient service, so patients with these diseases can get a higher reimbursement ratio and a larger reimbursement amount.

What expenses are not included in Qingdao outpatient co-ordination reimbursement limit? According to the regulations of Qingdao Medical Insurance Bureau, the following expenses are not included in the scope of outpatient co-ordination reimbursement limit: 1. Free medical care, free medicines, use of ambulances equipped by the unit, and mediation to properly handle medical disputes; 2 residents outpatient special disease treatment costs; 3 disease vaccination, physical examination and other expenses.

The reimbursement quota of outpatient department in Qingdao is a policy to control the expenditure of medical insurance fund and make the guarantee more reasonable. It should be noted that the higher the medical insurance expenses paid by individuals, the higher the reimbursement ratio, and some diseases are not limited by the quota.

Legal basis:

"People's Republic of China (PRC) Medical Insurance Law" Article 18 The collection and use of medical insurance funds shall be legal, fair and open, with two lines of revenue and expenditure and unified management and supervision by the society.