How much can medical insurance reimburse itself?

If you are an on-the-job employee, you can only reimburse more than 2,000 yuan for medical expenses after seeing a doctor in the emergency department of the hospital, and the reimbursement ratio is 50%. For retirees under the age of 70, the expenses above 1300 yuan can be reimbursed, and the reimbursement rate is 70%. For retirees over 70 years old,180% of the expenses above 300 yuan can be reimbursed.

No matter what kind of people, the maximum payment limit for outpatient and emergency medical expenses is 20 thousand yuan.

If you use the social security card to see a doctor directly, you don't have to reimburse. If it is hospitalization reimbursement, first register hospitalization with social security card, and then submit it to the Social Security Bureau for approval by the permanent representative of the hospital. After passing the examination, you can directly use the social security card to leave the hospital.

Proportion of social security card reimbursement for medical treatment:

First, the use of special medical materials or disposable medical materials with a unit price of more than/kloc-0,000 yuan, as well as the installation and replacement of artificial organs, shall be paid by the basic medical insurance pooling fund at 90% of the domestic general price;

Second, 90% of the basic medical expenses for outpatient dialysis of chronic renal failure, outpatient anti-rejection drugs after organ transplantation, outpatient chemotherapy, radiotherapy, interventional therapy or radionuclide therapy are paid by the basic medical insurance pooling fund;

Third, the outpatient special examination and treatment costs are paid by the basic medical insurance fund 80%, and the individual pays 20%;

Fourth, continuous payment is linked to the reimbursement ratio. After two years of continuous insurance, the reimbursement rate increased to 765,438+0%, and after four years of continuous insurance, the reimbursement rate increased to 72%, and so on.

What are the conditions for medical insurance reimbursement?

1. In order to obtain medical insurance reimbursement for medical behavior in designated institutions, first of all, the insured person needs to see a doctor or buy medicine in designated medical institutions and pharmacies stipulated by the basic medical insurance in order to obtain reimbursement, otherwise it cannot be reimbursed.

2. If it belongs to the social security catalogue, it is necessary to have medical treatment items or purchased drugs in the social security catalogue to be reimbursed, otherwise it cannot be reimbursed.

3. To reach the deductible standard, medical insurance reimbursement is required. First, the medical expenses incurred by the insured reach the deductible line stipulated by social security, and the part exceeding the deductible line can only be reimbursed within the limit, and the unified proportion is paid by the basic medical pooling fund.