What is the reimbursement rate of hospitalization medical insurance in Chengdu?

The proportion of medical insurance reimbursement in Chengdu is determined according to the categories of insured persons. In a settlement year, medical expenses that meet the scope of reimbursement occur. The minimum threshold for tertiary hospitals is 500 yuan, the minimum threshold for secondary hospitals is 300 yuan, and there is no minimum threshold for primary hospitals.

First, students and children. In a settlement year, medical expenses below RMB 6,543,800+0,800 yuan that meet the scope of reimbursement occurred. The threshold for tertiary hospitals is 500 yuan, and the reimbursement ratio is 55%; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

The second is the elderly over 70 years old. In a settlement year, medical expenses below RMB 6,543,800+that meet the scope of reimbursement occur, and the threshold of tertiary hospitals is 500 yuan, and the reimbursement ratio is 50%; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

Third, other urban residents. In a settlement year, medical expenses below RMB 6,543,800+that meet the scope of reimbursement occur, and the threshold of tertiary hospitals is 500 yuan, and the reimbursement ratio is 50%; The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.

Payment standard

In 2023, the payment standard of basic medical insurance for urban and rural residents (students and children) in Chengdu is 350 yuan/person/year (including basic medical insurance for urban and rural residents, serious illness insurance for urban and rural areas, supplementary medical insurance for serious illness, and long-term care insurance).

payment types/methods

Online payment

1. Pay attention to the official WeChat account "Chengdu Medical Insurance", click the "Convenience Service" button to enter the "Intensive Platform" module, click "Pension Medical Insurance Payment", and choose any online payment channel of the bank for online payment.

2. Pay attention to the official WeChat account of "Chengdu Taxation", enter the "I want to do something"-"Social Security Payment" module, and choose any online payment channel of the bank for online payment.

3. Pay attention to the official account of WeChat, the official WeChat of "Chengdu Tax". In the "I want to do something"-"Social Security Payment" module, log in to "Sichuan Electronic Taxation Bureau of People's Republic of China (PRC) State Taxation Bureau", enter the social security payment page, click "Pay" and follow the system prompts.

4. Tianfu citizen cloud "People's livelihood security-social security payment".

5. Alipay "Citizen Center-Social Security-Social Security Payment".

6. WeChat "Service-City Service-Social Security-Social Security Payment".

7. Mobile banking, WeChat banking, online banking, etc. Provided by the social security fee collection bank (the specific payment method is subject to the bank regulations).

Offline payment

1. Payment service outlets in towns (streets) and villages (communities).

2. School kindergarten.

3. Social security fee collection bank outlets (payment outlets shall be subject to bank regulations).

Legal basis:

Article 29 of the Regulations of People's Republic of China (PRC) Municipality on the Basic Medical Insurance for Urban Employees.

The hospitalization expenses for major diseases are paid in the following ways:

(a) Qifubiaozhun in principle control in the city, county, autonomous county last year, the average social wage of workers 9%-0%.

(two) the maximum payment limit is controlled in principle at 3-5 times of the average social wage of employees in cities, counties and autonomous counties in the previous year.

(three) medical expenses above the minimum deductible and below the maximum payment limit are mainly paid by the overall fund, and individuals bear a certain proportion.

Give appropriate care to the proportion of retirees who bear medical expenses.

The scope of serious diseases, the specific standards of Qifubiaozhun and the maximum payment limit, and the proportion of sharing medical expenses above Qifubiaozhun and below the maximum payment limit shall be determined by the provincial people's government.