How much can the social security bought in Mayong, Dongguan be reported to Dongguan People's Hospital for medical treatment and hospitalization?

If medical insurance is paid, employees can use it in the overall planning area, and the reimbursement ratio is not necessarily. As long as the drugs meet the medical catalogue, they can be reimbursed, and the reimbursement amount does not have to be determined according to the actual situation.

Proportion of reimbursement for community outpatient service:

1, 70% can be reimbursed for seeing a doctor in a designated community service institution or referring to the community health service center in this calm point;

2. Referral to the outpatient department of Calm Point Hospital or designated specialist hospital can be reimbursed by 60%;

3, referral to the city's three designated hospitals for outpatient treatment, can be reimbursed 50%;

4, referral to other medical institutions, the basic medical insurance fund will not be reimbursed;

5, in this quiet point community health service center outpatient rescue, can be reimbursed 70%;

6, directly to the city medical institutions outpatient rescue, can be reimbursed 60%. In the designated community health service institutions outside the service hours, can be reimbursed 70%.

Remarks: Reimbursement expenses must meet the basic medical expenses stipulated by Dongguan.

The adjustment of social medical insurance in Dongguan includes basic medical insurance and supplementary medical insurance. In terms of basic medical insurance, the maximum payment limit of basic medical expenses incurred by the insured for more than three years will be raised from 200,000 yuan to 300,000 yuan per year, and the increase in payment ratio will be implemented according to the original standard of 6,543,800 yuan+0.5 million yuan.

When the insured person is hospitalized due to illness, the basic medical expenses that meet the scope of social insurance drug list, diagnosis and treatment items and medical service facilities will be subsidized by the supplementary medical insurance fund according to the proportion of segments while enjoying the basic medical insurance benefits: more than 50,000 yuan and less than or equal to 654.38+ 10,000 yuan, with a subsidy of 20%; More than150,000 yuan, less than or equal to150,000 yuan, 30% subsidy; If it exceeds 6.5438+0.5 million yuan and does not exceed the basic medical expenses corresponding to the maximum payment limit of basic medical insurance, the subsidy will be 40%. The proportion of hospitalization supplementary medical insurance fund payment has also been adjusted.

In addition, the out-of-pocket proportions of drugs with 20% and 40% of medical insurance for inpatients were adjusted to 15% and 30% respectively.

Social insurance law

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.