Proportion of hospitalization reimbursement for medical insurance in Hangzhou

Legal analysis: the proportion of hospitalization expenses remains at about 75%, and the treatment, scope and payment standards are unified. Reasonable determination of urban and rural residents medical insurance deductible, payment ratio, maximum payment limit and other treatment standards, the proportion of hospitalization expenses within the scope of the policy remains at around 75%, and the deductible line is continuously calculated for eligible referral inpatients in the overall planning area. Improve the differential payment policy of medical insurance in different levels of medical institutions and promote graded diagnosis and treatment. Further improve the support policies for medical insurance clinics for urban and rural residents, establish and improve the overall planning and payment mechanism for medical insurance clinics for urban and rural residents, focus on ensuring frequently-occurring diseases and chronic diseases with heavy burdens on the masses, and include outpatient drugs such as hypertension and diabetes in the scope of medical insurance reimbursement.

The hospitalization reimbursement standard is related to the hospital level where the insured lives:

1. If you live in a tertiary hospital, the employee pays 15%, that is, 85% is reimbursed, and the minimum threshold is 30,000 yuan.

Expenses ranging from 23,000 yuan to 40,000 yuan are paid by employees themselves 10% and reimbursed by 90%.

3, more than 40000 yuan to the maximum payment limit, 95% can be reimbursed, employees only need to pay 5%.

4, and the individual contribution ratio of retirees is 60% of the on-the-job (that is, the above-mentioned) employees, but below the minimum threshold, they are all paid by individuals.

Legal basis: Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid by the basic medical insurance fund according to state regulations.