Chongqing social security maternity reimbursement ratio

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What is the reimbursement ratio of Chongqing residents' medical insurance in 2017? JinTou said that Chongqing residents' medical insurance is for urban and rural residents whose household registration is in the city and who have not participated in urban workers' medical insurance, including students enrolled in primary and secondary schools, secondary vocational schools, special education schools, and young children in childcare institutions (hereinafter collectively referred to as urban and rural residents), as well as full-time undergraduate and specialist students at Yuyu colleges and universities (including private colleges and universities, scientific research institutes), and postgraduates (hereinafter collectively referred to as college students); in 2017 newborns who were born and have household registration in the city.

Reimbursement Note 1: General outpatient flat-rate lump-sum funds will no longer be carried forward for discontinuous enrollment

Residents' health insurance enrollees who incur general outpatient expenses can use the general outpatient flat-rate lump-sum, which was 80 yuan per person in 2016. The flat-rate lump-sum funds can be used for outpatient medication purchases or hospitalization out-of-pocket expenses incurred by the participants themselves, their relatives or designees. Any unused balance in the current year can be carried forward for use across years.

Participants can use all of the general outpatient flat-rate subsidy amount and the reimbursement rate is 100%. It is important to note that the general outpatient flat-rate subsidy belongs to the residents' medical insurance fund and does not belong to individuals. For residents who are not continuously insured and have not paid their contributions, the unused flat-rate subsidy will not be carried over and used.

Reimbursement Note 2: can be fixed in primary medical institutions in proportion to the reimbursement of 100 yuan

In 2017, the insured urban and rural residents and independently insured newborns in addition to enjoying the outpatient fixed lump sum reimbursement, but also enjoy the reimbursement of the general outpatient co-ordination of the primary health care institutions, the reimbursement standard is as follows: in the primary health care institutions (township health centers, community service centers (stations), village health clinics, and social health departments below the first level) The reimbursement standard is as follows: for the insured who are designated in the primary medical institutions (township health center, community service center (station), village health center, and social medical institutions below the first level) and incur the general outpatient expenses covered by the city's medical insurance, the residents' medical insurance fund reimburses them at a rate of 60%, with an annual reimbursement limit of 100 yuan/person; for the insured who are not designated in the primary medical institutions and incur general outpatient expenses covered by the city's medical insurance, the residents' medical insurance fund reimburses them at a rate of 60%, with an annual reimbursement limit of The annual reimbursement limit is 60 yuan per person.

The general outpatient clinic of college students for the academic year of September 2016-August 2017 will be co-ordinated by the internal medical institutions affiliated with their units at a fixed rate of 100 yuan/person, and the funds will be used exclusively for this purpose. The general outpatient reimbursement rate and reimbursement limit are in accordance with the relevant regulations of the city.

How much can I be reimbursed after enrollment at present?

Calculation: reimbursement amount = (medical expenses eligible for reimbursement under medical insurance - threshold fee) x reimbursement ratio

The first level and the following fixed-point medical institutions deducted the threshold fee of 100 yuan/trip, the reimbursement of Class A medicines in one grade: 80% of the first grade, 85% of the second grade; the reimbursement of Class B medicines will be made first with an out-of-pocket payment of 10%, and then reimbursement will be made according to the ratio of 80% and 85%;

The second level fixed-point Medical institutions deduct 300 yuan/times the threshold fee, Class A drugs reimbursement: 60% of the first class, 65% of the second class; Class B drugs first 10% out-of-pocket, then reimbursement at the rate of 60%, 65%;

Tertiary fixed-point medical institutions deduct 800 yuan/times the threshold fee, Class A drugs reimbursement: 40% of the first class, 45% of the second class; Class B drugs first 10% out-of-pocket, then reimbursement at the rate of 40%, 45% reimbursement;

Current annual reimbursement ceiling: 80,000 yuan for the first grade, 120,000 yuan for the second grade