Tianjin children's medical insurance outpatient reimbursement policy 2023

I. Tianjin Children's Medical Insurance Card Reimbursement Standard

① The deductible standard of medical expenses in tertiary hospitals is 500 yuan, and the reimbursement rate is 50%; ② The deductible standard of medical expenses in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; ③ The reimbursement rate of medical expenses in primary hospitals (community health service centers) is 60%.

④ The maximum reimbursement for children's medical insurance in Tianjin is 6.5438+0.8 million yuan.

In this year, the reimbursement rate of outpatient (emergency) medical expenses of children in first-class hospitals and community medical institutions in 800 yuan that meet the reimbursement conditions is 30%.

Two, Tianjin children's social security card processing process

1. Tianjin children's social security card application materials: the original household registration book+a copy of the first page of the household registration book and the child's own page, and the original and copy of the agent's ID card.

2. Tianjin children's social security card processing location: the street office where the household registration is located.

3. Tianjin children's social security card processing fee: RMB 100 per person per year, and 60 yuan is paid by individuals. The government subsidizes 40 yuan for students and children from families with disabilities and special difficulties. Individuals do not pay fees, and the government subsidizes 100 yuan.

4. Tianjin children's social security card benefits: hospitalization 50%, emergency 50% (it seems that the baby medical insurance card can only be hospitalized).

Note: Do it after reimbursement. After registration, you can pick up the list according to the notice of the street office, which usually takes 45 working days.

Legal basis:

Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, standards of medical service facilities and medical expenses for emergency rescue, and shall be paid from the basic medical insurance fund in accordance with state regulations.