What is the proportion of medical insurance reimbursement in Jiangxi?

The reimbursement ratio of medical insurance in different places in Jiangxi is as follows:

1, outpatient reimbursement ratio: there is no deductible line for general outpatient service, and all insured residents enjoy the treatment of general outpatient service.

2. Proportion of reimbursement for hospitalization: The longer the continuous insurance period, the greater the reimbursement ratio. For every five years of continuous payment by insured residents, the proportion of hospitalization reimbursement of medical insurance fund will be increased by 5 percentage points, and the cumulative reimbursement ratio will not exceed 10 percentage point.

3. Secondary reimbursement ratio: There may be "secondary reimbursement" after "secondary reimbursement". The medical expenses incurred by the insured residents in a single hospitalization belong to the part within the scope of payment of the basic medical insurance fund for urban residents. After the basic medical insurance fund is paid in proportion, the part of the individual burden exceeding 8,000 yuan will be reimbursed by the serious illness insurance fund at a rate of 55%.

The reimbursement process of medical insurance in different places in Jiangxi is as follows:

1. Download the Application Form for Working and Living in Different Places of Municipal Basic Medical Insurance (hereinafter referred to as the "Application Form") on the social security website;

2, according to the provisions of the fill in, and by the foreign social insurance (medical insurance) agencies stamped "declaration form";

3 will fill out the "declaration form" back to the social insurance agency responsible for the division of labor for review and confirmation. Need to apply for a medical card in different places in the province, with the "declaration form" after examination and confirmation to the municipal social security center audit department for registration, and then to the social security card management department for the card making procedures in different places in the province;

4. After filing, the personal social security card of the insured person can no longer be used; If the insured person returns for medical treatment, he should go to the municipal social security agency for cancellation of medical registration, and his personal social security card can be used in designated medical institutions from the next day;

5. Implement the principle of reporting changes but not reporting.

To sum up, the proportion of reimbursement for medical insurance in different places in Jiangxi Province is 88% for those whose threshold is above 3,000 yuan, 90% for those between 3,000 and 5,000 yuan, 92% for those between 5,000-110,000 yuan, and 95% for those above the highest payment limit. Residents' medical insurance is up to 50%, and employees' medical insurance is up to 80%.

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.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.