Is the proportion of medical insurance reimbursement in Guangzhou the same as that in Guangzhou?

The reimbursement rate of medical insurance in different places in Guangzhou is the same as that in the local area.

The social medical insurance fund for employees shall pay the medical expenses of the insured in different places according to the standards of the designated medical institutions at the same level in this Municipality.

The basic medical expenses above the hospitalization Qifubiaozhun of the employees' social medical insurance insured shall be paid by the overall fund according to the following proportions:

1. Employees: 90% of first-class designated medical institutions, 85% of second-class designated medical institutions and 80% of third-class designated medical institutions;

2. Retirees: 93% of first-class designated medical institutions, 89.5% of second-class designated medical institutions and 86% of third-class designated medical institutions.

Medical insurance reimbursement process in different places:

1, medical expenses of medical insurance personal account are reimbursed by medical insurance in different places. You can go to the medical insurance bureau regularly to handle the fund transfer procedures and transfer the medical insurance fund in the social security card account to your own bank account. Under normal circumstances, outpatient medical expenses are paid by individuals;

2. If you are hospitalized, the reimbursement of medical insurance in different places needs to be reported to the Medical Insurance Bureau for the record. When I leave the hospital, I will go to the medical insurance bureau to settle the hospitalization expenses with the hospital's diagnosis certificate, discharge summary, medication list, medical expense receipt and medical guarantee. If I can't come, I can also entrust an agent to handle it.

3. Provincial hospitals should be designated hospitals for local medical insurance;

4. The reimbursement rate is 88% for the threshold fee of more than 3,000 yuan, 90% for 3,000-5,000 yuan, 92% for 5,000-10000 yuan, and 95% for the maximum payment limit of more than10000 yuan, including 80% for Class B drugs and 70% for precious drugs, and special inspection. Medical expenses of individual medical insurance accounts can be transferred to the medical insurance bureau regularly, and hospitals in other provinces should be designated hospitals for local medical insurance.

To sum up, if you go to a hospital in other provinces for medical treatment, it must be a local medical insurance designated hospital. The minimum payment standard is 88% for above 3000 yuan, 90% for 3000-5000 yuan, 92% for 5000- 10000 yuan, and 95% for above 10000 yuan within the maximum payment limit.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.