2023 Shandong urban residents medical insurance how to reimbursement and reimbursement ratio, with online payment method

A, Shandong urban residents medical insurance how to reimbursement and reimbursement ratio 1, outpatient reimbursement

General outpatient does not set a starting line all the insured residents enjoy general outpatient treatment. A medical insurance year, general outpatient without a starting line, into the outpatient coordinated fund within the scope of payment of medical expenses reimbursement at a rate of 60%, the coordinated fund annual individual maximum payment limit of 400 yuan.

2, hospitalization reimbursement rate

Continuous participation in the longer the reimbursement rate the greater the insured residents continuous contributions for every 5 years, the hospitalization reimbursement rate of the health insurance fund increased by 5 percentage points, the cumulative total of not more than 10 percentage points. If you have been insured for 10 consecutive years since 2007, then the hospitalization reimbursement rate in a tertiary, secondary, or primary hospital will be 70%, 80%, and 90% respectively.

3, the second reimbursement rate

"Second reimbursement" may also have "reimbursement" in the insured residents single hospitalization of medical costs incurred in the urban residents of the basic health insurance co-ordination fund within the scope of the payment of the part in the basic health insurance co-ordination fund. After the proportional payment, the personal burden of more than 8,000 yuan above the part of the funds of the major disease insurance for more than part of the proportion of 55% to give the "second reimbursement".

The medical expenses incurred by insured residents who have been hospitalized several times a year, after the basic medical insurance and the "secondary reimbursement" payment, the part of the hospitalized medical expenses (including the compliant and reasonable out-of-pocket expenses) borne by an individual exceeding 25,000 RMB in a cumulative manner in a year shall be reimbursed again at a rate of 55% of the excess by the funds of the major disease insurance. "reimbursement", the annual individual maximum payment limit of 250,000 yuan from the major disease insurance funds.

4, the amount of reimbursement

The maximum annual reimbursement of 370,000 yuan to participate in the city's urban residents health insurance residents, its annual payment limit of 120,000 yuan of basic medical insurance, the payment limit of 250,000 yuan of major medical insurance. Therefore, participants can be reimbursed up to 370,000 yuan per year.

Shandong urban residents medical insurance online payment method medical insurance in the online payment method is as follows:

1, mobile banking APP, log in the mobile banking APP, click on the following menu "life", "social security "

1, mobile banking APP, login to the mobile banking APP, click on the following menu "life", "social security", select "payment area", select "payment unit" to pay the bill successfully.

2, WeChat payment, click on WeChat inside the lower right corner of the "I", "payment", "into the life of the payment", select the city and click on "". Social security payment" can be.

3, Alipay payment, find the "city services" to choose the city of payment in the office hall column, select "medical insurance", "residents of medical insurance payment" can be.

The individual account of the medical insurance is a special account set up according to the basic medical insurance policy, specifically for storing the medical insurance premiums paid by the participants and a certain proportion of the funds transferred from the employer's contribution, and recording the medical consumption. The funds in the individual account are used to pay for the out-of-pocket portion of the costs of medical treatment and drug purchases.