What is the reimbursement rate for children in hospital?

The proportion of children's hospitalization reimbursement depends on the specific situation.

The reimbursement standards are as follows:

1. Infant insurance is a kind of personal risk protection provided by insurance companies for people of specific ages from 0 to 15. Basic medical insurance is a social insurance system established to compensate workers for economic losses caused by disease risks. Generally speaking, the price of children's health insurance is about one year 100 yuan. Of course, due to the different economic level of the area where you live, the amount paid will be different.

2. Children's medical insurance is social insurance, and the premium is usually not very high. Take Shenzhen as an example. The annual cost of children's medical insurance is around 400 yuan, which most families can afford. The payment period of children's medical insurance is once a year, which is very important for children. So I suggest you apply as soon as possible. After all, the insurance conditions of this kind of insurance are relatively loose, and there is no threshold limit. As long as you meet the insurance conditions, you can apply for insurance. For newborns, it is best to choose to handle it within three months after birth, so that the expenses incurred since birth can be reimbursed. If it is handled after three months of birth, the previous expenses cannot be reimbursed.

3. The annual funding standard for students and children is 100 yuan, of which the amount of medical insurance premiums paid by individuals is 60 yuan, and the rest of 40 yuan is partially subsidized by the government.

In addition, for some children and students from low-income families and severely disabled children, only 10 yuan is paid in some areas, and some local individuals do not pay, and the medical insurance expenses are fully subsidized by the government financial department.

Medical insurance reimbursement process:

1. Confirm reimbursement scope: During the treatment, you need to confirm whether your treatment items are within the scope of medical insurance reimbursement;

2. Collect reimbursement materials: collect relevant treatment records, drug receipts, medical expense lists and other relevant materials;

3. Go to the social security department for reimbursement: submit relevant materials for medical insurance reimbursement to the local social security department;

4. Pending review: The social security department will conduct relevant review and comparison to confirm the reimbursement ratio and reimbursement amount; Receive reimbursement: After approval, you can receive medical insurance reimbursement at the designated bank.

To sum up, the reimbursement ratio of children's hospitalization medical insurance generally needs to be determined according to their own choice. First-class hospitals do not have deductible expenses, and generally can reimburse 65% of the expenses. 300 yuan, the deductible line of secondary hospitals, can reimburse 60% of hospitalization expenses, and 500 yuan, the deductible line of tertiary hospitals, can reimburse 55% of hospitalization expenses. It is best to go to a local regular hospital for relevant consultation.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, 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.