Foshan City employee medical insurance outpatient reimbursement ratio is how much

Employee medical insurance outpatient reimbursement ratio:

Employees, after visiting the outpatient and emergency clinic of the hospital, only medical expenses above 2,000 yuan can be reimbursed, and the reimbursement ratio is 50%. In the case of retirees under the age of 70, expenses above 1,300 yuan can be reimbursed, and the reimbursement rate is 70 percent. If the retiree is over 70 years old, expenses over $1,300 can be reimbursed the reimbursement rate is 80%. And no matter which category you are in, the maximum amount of expenses paid for outpatient and emergency major medical expenses is $20,000 dollars. For example, if you are an active employee and spend $2,500 on an outpatient visit, the $500 portion can be reimbursed at 50 percent, which is $250.

The outpatient reimbursement rate of the residents' health insurance:

Outpatient settlement procedure: medical expenses incurred by insured patients attending the clinic at the designated medical institutions will be settled by swiping the card at the residents' health insurance settlement counter directly with the special prescription for health insurance and the social security card. Within an insurance year, the total general outpatient expenses under 50 yuan, the health insurance fund pays 4O%, more than 50 yuan of the cost of personal expenses.

Three, rural health insurance outpatient reimbursement rate:

1, village health clinic and village center health clinic visit reimbursement of 60%, each visit to the prescription drug cost limit of 10 yuan, the health center doctor temporary rehydration prescription drug cost limit of 50 yuan.

2. Township health centers are reimbursed 40% of the cost of each visit, with a limit of 50 yuan for each examination and surgery, and a limit of 100 yuan for prescription drugs.

3. 30% of the reimbursement will be made to secondary hospitals, with a limit of 50 yuan for each examination and operation and 200 yuan for prescription drugs.

4. Tertiary hospitals will reimburse 20% of the cost, with a limit of 50 yuan for each examination and operation and 200 yuan for prescription drugs.

5. Chinese herbal medicine invoices attached to the prescription are limited to 1 yuan per sticker.

6. The annual limit of outpatient compensation for town-level cooperative medical care is 5,000 yuan.

Outpatient reimbursement rate for special diseases

Employee health insurance: within a health insurance year, the starting line for outpatient treatment of special diseases is 400 yuan, and the reimbursement rate for medical expenses in line with the scope of treatment is the same as that of general hospitalization.

Urban and rural residents' medical insurance: within a medical insurance year, the starting line for outpatient treatment of special diseases is 400 yuan, and the reimbursement rate of medical expenses in accordance with the scope of treatment is the same as that of general hospitalization.

Outpatient special diseases are currently 12 kinds of diseases

1, malignant tumors;

2, uremia outpatient renal dialysis;

3, tissue and organ transplantation outpatient treatment;

4, organ failure (heart, lung, liver, kidney); (5) cerebrovascular accidents during the recovery period;

5, hypertensive disease third stage (with heart, brain, kidney, eye complications) , brain, kidney, eye complications of one of the people;

6, diabetes mellitus (co-infection or heart, kidney, eye, neurological complications of one of the people);

7, chronic aplastic anemia;

8, systemic lupus erythematosus (with the heart, lung, liver, kidney and neurological complications of one of the people);

9, severe mental retardation disease;

10, hemophilia; (12) chronic hepatitis B (active hepatitis B), cirrhosis of hepatitis B, chronic hepatitis C. (17 years of data in a place)

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