Policy of reimbursement for residents' medical insurance outpatient service in 2023

In 2023, the reimbursement policies for residents' medical insurance clinics are as follows:

1, the reimbursement rate of village clinics and village center clinics is 60%, the prescription is 10 yuan, and the prescription for temporary fluid replacement is 50 yuan.

2. Reimbursement of 40% for medical treatment in town health centers, with the limit of examination fee and operation fee for each visit, and the limit of prescription fee 100 yuan.

3, the secondary hospital reimbursement of 30%, each examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan.

4, tertiary hospital reimbursement of 20%, each visit examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan.

5. The prescription attached to the invoice of traditional Chinese medicine is limited to 1 yuan, and the annual compensation limit of town-level cooperative medical clinic is 5000 yuan.

How to use residents' medical insurance outpatient service;

1, before seeing a doctor, you need to register in the hospital outpatient department and choose the corresponding department and doctor to see a doctor.

2. When you see a doctor, you need to take the initiative to inform your doctor about your medical insurance and show your social security card or ID card and other relevant documents.

3. After diagnosis, you need to pay the corresponding outpatient expenses, and get the outpatient invoice and expense list.

4. After payment, settlement and reimbursement can be made through social security card or ID card. The reimbursement rate of residents' medical insurance clinics is generally between 50% and 90%, and the specific reimbursement rate varies according to different regions and policies.

It should be noted that different regions and medical institutions may have different processes and infections when using residents' medical insurance clinics, subject to local policies and hospital regulations.

Medical insurance for urban residents:

Urban residents' medical insurance is a medical insurance system with urban minors and unemployed residents who have not participated in urban workers' medical insurance as the main participants. Major measures to further solve the medical security problems of the broad masses of the people and continuously improve the medical security system. Mainly to make institutional arrangements for medical insurance for urban non-employed residents.

Unlike employee medical insurance:

1, different. Medical insurance for urban workers is mainly for employees and retirees who have work units or are engaged in individual economy. Medical insurance for urban residents is mainly for urban non-employees such as elderly residents, low-income objects, severely disabled people, students and children who have urban household registration and have no jobs;

2. The payment standard and source are different. Medical insurance for urban workers is jointly paid by employers and individual workers, and does not enjoy government subsidies. The payment standard of urban residents' medical insurance is generally lower than that of employees' medical insurance, and the government gives appropriate subsidies on the basis of individual contributions;

3. Different treatment standards. Due to the low level of financing, the medical treatment standard of urban residents' medical insurance is slightly lower than that of employees' medical insurance.

4. Different payment requirements. If the minimum payment period is set for medical insurance for urban workers, if the payment period reaches 25 years for men and 20 years for women, they can enjoy basic medical insurance benefits without paying after retirement; There is no minimum payment period for urban residents' medical insurance, which must be paid every year. If you don't pay, you won't enjoy the treatment.