How to report the second reimbursement of medical insurance?

According to the regulations, when the current basic medical insurance is used to pay the hospitalization expenses for the first time in a year, the deductible amount of both working and retired people is 1300 yuan.

The medical expenses for the second and subsequent hospitalization are determined according to the deductible line of 50%, which is 650 yuan. The maximum annual payment limit (hospitalization expenses) of the basic medical insurance pooling fund is currently 70,000 yuan.

The individual contribution ratio of retirees is 60% of the individual contribution ratio of employees, but the part below the minimum deductible is the same, and all of them are paid by individuals. The standard of hospitalization reimbursement is related to the level of the medical institution where the insured person is located. Note: Outpatient service and hospitalization are two deductible lines.

Medical insurance refers to social medical insurance. Social medical insurance is a social insurance system established by the state and society according to certain laws and regulations to provide basic medical needs for workers within the scope of protection. The basic medical insurance fund consists of overall funds and individual accounts. The basic medical insurance premiums paid by individual employees are all included in individual accounts; The basic medical insurance premium paid by the employer is divided into two parts, one part is included in the personal account, and the other part is used to establish the overall fund.

Extended data:

Medical insurance has the characteristics of "low level and wide coverage". The payment is based on the expenses that most units and individuals can bear at a low level, covering all units and employees in cities and towns, and employees in different units can enjoy the rights of basic medical insurance. The insured can enjoy it for life after completing the payment period. Secondly, the basic medical insurance has the characteristics of "the burden of both parties and the combination of unified accounts"; Based on the principle of "balance of payments".

Enjoy treatment according to uniform standards. The same access conditions, the same fees, the same treatment, there is no difference between high and low. The employee's outpatient expenses can be deducted from his personal account and paid by the employee after deduction. The hospitalization expenses of employees shall be reimbursed in proportion: 1 1,000 yuan, and 86% of the expenses shall be reimbursed by tertiary hospitals; 65,438+0,000 to 20,000 yuan, and 88% of the expenses are reimbursed by tertiary hospitals; 20,000 to 40,000 yuan, and 92% of the expenses are reimbursed by tertiary hospitals. If employees have not been sick for several years in a row, personal account funds can be accumulated.

References:

Baidu encyclopedia-medical insurance