How much can Zhengzhou community residents' medical insurance card be reimbursed?

Measures of Zhengzhou Municipality on Basic Medical Insurance for Urban Residents

Article 25

Insured residents in designated medical institutions in accordance with the provisions of the hospitalization medical expenses, Qifubiaozhun below the cost paid by individuals; The expenses above Qifubiaozhun and below the maximum payment limit shall be borne by the overall fund and individual insured residents in proportion.

Residents' medical insurance hospitalization pooling fund Qifubiaozhun according to different types of designated medical institutions are divided into:

300 yuan, designated medical institution;

600 yuan, a secondary designated medical institution;

900 yuan, a tertiary designated medical institution.

The medical expenses incurred by the insured residents in different types of designated medical institutions that meet the requirements above the Qifubiaozhun and below the maximum payment limit shall be borne in the following proportion:

A class of designated medical institutions (including community health service institutions), the overall fund to pay 60%, individuals bear 40%;

Two types of designated medical institutions, the overall fund to pay 55%, individuals bear 45%;

Three types of designated medical institutions, the overall fund to pay 50%, individuals bear 50%;

The insurance year of residents' medical insurance is calculated according to the natural year. In a natural year, the cumulative maximum payment limit of the overall fund is 25,000 yuan (including the prescribed disease expenses for hospitalization and outpatient service).

Extended data

The use of social medical insurance card is as follows:

1, scope of use of medical insurance card

Insured employees can swipe their cards on POS machines with passwords when purchasing medicines in designated hospitals and pharmacies, but they cannot withdraw cash or transfer money.

2, medical insurance card balance query

Insured employees can inquire about the balance by telephone, or at China Bank Savings Office or designated hospitals and pharmacies in urban areas. You can also log in to the social security inquiry system online.

3, medical insurance card transaction query

Insured employees can print medical insurance card transaction records with their ID cards and medical insurance to China Bank Savings Office, including expenditure records and consumption records of personal account funds. If you have any questions about the transaction records, you can go to the retail business department of Bank of China.

4, medical insurance card password

If the insured employees change their passwords, they can make changes by phone, or they can make changes with their ID cards at China Bank Savings Office. If the insured employee forgets his password, he can report the loss of the original password with his ID card to China Bank Savings Office and change it.

5, medical insurance card custody

Insured employees should take good care of their medical insurance cards. If you accidentally lose it, please immediately issue a letter of proof to the unit and stamp it in the medical insurance office for confirmation. Then, they will take their ID cards to China Bank Savings Office to report the loss and go through the replacement procedures. After 7 days, they can get a new card.

6. Matters needing attention

When the number of medical insurance card transactions reaches 60, the insured employees must print the transaction records at China Bank Savings Office, or stop using the card. After the transaction record is printed, the card can continue to be used.

Baidu encyclopedia-social medical insurance card

Baidu Encyclopedia-Measures of Zhengzhou Municipality on Basic Medical Insurance for Urban Residents