What does the threshold fee mean?

Threshold fee is a popular name of the common people, and the definition of national medical insurance is deductible, and its normative name is pooling fund deductible standard, that is, the deductible standard of hospitalization medical expenses for urban workers and residents.

The "threshold fee for hospitalization insurance" is not within the scope of reimbursement and can only be deducted according to the patient's own expenses. In other words, the hospitalization expenses of the insured person can only be reimbursed according to the relevant medical insurance policies after the hospitalization expenses exceed the Qifubiaozhun, and the hospitalization expenses below the Qifubiaozhun are borne by the patients.

For example, the "threshold fee" for urban residents' basic medical insurance hospitalization is 100 yuan for community health service centers, first-class, second-class and third-class hospitals, 200 yuan, 300 yuan and 400 yuan respectively. The "threshold fee" is not included in the medical expenses used, and the individual pays for Class B drugs first 10%.

The remaining expenses are reimbursed by 75%, 70%, 65% and 60% respectively according to the community health service center and the first, second and third level hospitals. However, due to various types of social security, including basic medical insurance for urban workers, basic medical insurance for urban residents and new rural cooperative medical system, the threshold cost of hospitalization insurance will be different.

Different levels of hospitals charge different standards for "threshold fees". The higher the level, the more "threshold fees" will be charged. The purpose of establishing such a "threshold" is to guide people to seek medical treatment reasonably, prevent some patients with minor illnesses from being hospitalized at will, make limited medical resources tense, and reduce the occurrence of "minor illness cured" and "hospitalization without hospitalization".

These are just national policies. For some first-tier cities with better economic conditions, residents' welfare benefits are better, so the above policy provisions are a bottom line. Provinces and cities with good economic conditions will have a slightly higher proportion of medical insurance reimbursement, and the threshold fee for hospitalization insurance will be slightly lower.