What is the latest reimbursement ratio of medical insurance in different places in 2023?

I. Conditions for reimbursement of medical insurance in different places 1. For the insured who have gone through the registration procedures for medical treatment in different places, such as resettlement, visiting relatives, working and studying abroad, the medical expenses incurred in designated medical institutions in different places will be paid in cash.

2, the provincial insured agreed to transfer to Beijing, Shanghai medical insurance designated medical institutions for medical expenses in cash.

Second, the proportion of medical insurance reimbursement in different places (up to 90%) 1, and the proportion of outpatient reimbursement.

There is no deductible line for general outpatient service, and all insured residents enjoy the treatment of general outpatient service. Within a medical insurance year, there is no deductible line for general outpatient service, and the medical expenses within the scope of outpatient co-ordination fund payment are reimbursed according to the proportion of 60%, and the annual maximum personal payment limit of co-ordination fund is 400 yuan.

2. Proportion of hospitalization reimbursement

. The longer the continuous insurance period, the greater the reimbursement ratio. The proportion of hospitalization reimbursement of medical insurance fund will be increased by 5 percentage points every 5 years after the insured residents pay continuously, and the cumulative reimbursement ratio will not exceed 10 percentage point. If you continue to participate in insurance 10 years from 2007, the reimbursement rates of hospitalization in tertiary, secondary and primary hospitals will reach 70%, 80% and 90% respectively.

3. Secondary reimbursement ratio

After the "second reimbursement", the medical expenses incurred by the insured residents in a single hospitalization belong to the part paid by the urban residents' basic medical insurance pooling fund, and there may be a "second reimbursement". After the basic medical insurance fund is paid in proportion, the personal burden exceeds 8,000 yuan, and the serious illness insurance fund gives "second reimbursement" to more than 55%.

After the basic medical insurance payment and "second reimbursement", the annual accumulated hospitalization medical expenses of the insured residents (including the compliant and reasonable self-funded part) exceed 25,000 yuan, and the excess part is "reimbursed" again by the serious illness insurance fund according to the proportion of 55%, and the annual maximum payment limit of the serious illness insurance fund is 250,000 yuan.

4. Reimbursement amount

The maximum annual reimbursement is 370,000 yuan for residents who participate in medical insurance for urban residents in our city. The annual payment limit for basic medical insurance is 6,543,800 yuan+0.2 million yuan, and the annual payment limit for serious illness insurance is 250,000 yuan. Therefore, Enoch Finance found that the insured can be reimbursed up to 370,000 yuan per year.

Iii. reimbursement process for medical insurance in different places 1. Receive or download the "Declaration Form for People Working and Living in Different Places of Basic Medical Insurance in this Municipality" (hereinafter referred to as the "Declaration 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. The insured person's personal social security card cannot be used after filing; 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.

4. Materials required for reimbursement of medical insurance in different places 1, and a copy of the application form for medical treatment in different places.

2. The formal invoice of pharmacy (supervised by State Taxation Administration of The People's Republic of China Finance Department, with the details of purchased drugs listed on the invoice) or the outpatient receipt of designated hospital.

3. Patient ID card and agent ID card

4. My passbook bank card account number (except for rural credit cooperatives) (bank name is required in external account)

Yin Weimin, Minister of Ministry of Human Resources and Social Security, said that solving the problem of direct settlement of medical treatment in different places will be divided into three steps.

The first step: realize the direct settlement of medical treatment in different places in the province. Statistics show that the proportion of medical treatment in different places in the province is the largest. By the end of 20 16, 30 provinces in China had achieved card settlement for medical treatment in different places within the province. The second step: in the first half of this year, the hospitalization expenses of retired and resettled people across provinces will be directly settled. Yin Weimin said: "When retired parents are taken to the place where their children work, they can directly see a doctor and settle accounts in different places."

Step 3: Before the end of this year, realize the direct settlement of hospitalization expenses of all eligible persons.

According to the report of Ministry of Human Resources and Social Security, the national remote medical treatment settlement system 20 16 was put into trial operation at the end of 2006. During the trial operation, 15 provinces have connected to the system and started the pilot project.

Medical treatment in different places is mainly aimed at four groups of people, namely:

1 Resettlement of retirees in different places, that is, people who have settled in different places after retirement and moved to their places of residence;

2. Long-term residents in different places refer to those who live in different places and meet the conditions of the insured place;

3. The resident in different places refers to the personnel who are stationed in different places by the employer and meet the conditions of the insured place;

4. Referrals from different places refer to those who meet the referral conditions of the insured place.

Previously, the medical expenses for medical treatment in different places were paid in advance by individuals, and after the treatment, I or my agent took the bill to the medical insurance center for reimbursement.

After the direct settlement of medical insurance across provinces and different places is realized, the insured citizens do not need to advance medical expenses (except at their own expense), and they do not need to take invoices for reimbursement. They only need to hold social security cards to seek medical treatment in designated hospitals. When seeing a doctor, the reimbursement ratio is directly settled on the card, and individuals only need to deposit their own funds directly on the card.