List of reimbursement ratio and scope of medical insurance in Qingdao in 2022

List of the proportion and scope of medical insurance reimbursement in Qingdao in 2022, please have a brief look with me.

Proportion of medical insurance reimbursement in Qingdao

1, the medical expenses incurred by the insured employees in hospital must be reimbursed by the individual deductible line. According to the requirements of our city, the deductible lines of first-,second-and third-level medical institutions are 500 yuan, 670 yuan and 840 yuan respectively. In a medical year, for the first hospitalization, the deductible standard shall be 100%, for the second hospitalization, the deductible line shall be halved, and for the third and above hospitalizations, the deductible line shall no longer be borne. The specific reimbursement ratio is as follows: level-1, level -2 and level-3 hospitals are less than 5,000 yuan, 88% 86% 84% 5,000 yuan-1 10,000 yuan, 90% 88% 86% 1 10,000 yuan-20,000 yuan-the maximum payment limit (200,000 yuan). (The maximum payment for large Medicaid is 200,000 yuan)

2, the insured elderly residents, severely disabled people, urban non-employees hospitalization medical expenses, before reimbursement must first carry out personal conceit deductible, the city requires the first, second and third level medical institutions deductible in 500 yuan, 670 yuan, 840 yuan. In a medical year, for the first hospitalization, the deductible standard shall be 100%, for the second hospitalization, the deductible line shall be halved, and for the third and above hospitalizations, the deductible line shall no longer be borne. The specific reimbursement ratio is as follows: the deductible of the first-level hospital, the second-level hospital and the third-level hospital within the grading interval is 75% 75% 65% 5000 yuan-10000 yuan 80% 70% 10000 yuan -20000 yuan 85% 75% 20000 yuan -20000 yuan.

3, the insured children and college students hospitalization medical expenses Qifubiaozhun, set up in accordance with the standards of tertiary medical institutions in 500 yuan and secondary medical institutions in 300 yuan. In a medical year, the first hospitalization, Qifubiaozhun according to 100%, the second hospitalization, Qifubiaozhun halved, the third and above hospitalization, no longer bear the Qifubiaozhun. Medical expenses above Qifubiaozhun are calculated cumulatively according to different grades; For the part below 5,000 yuan, tertiary medical institutions pay 80%, secondary and below medical institutions pay 85%, and the part above 5,000 yuan pays 90% uniformly. In a medical year, the maximum payment limit of the basic medical insurance fund is 1.72 million. 90% of the large Medicaid payment above the maximum payment limit (200,000 yuan) is reimbursed, and the personal burden is 10%. (The maximum payment for large-scale Medicaid is 200,000 yuan) For children who enjoy the treatment of only child, the basic medical insurance for hospitalization expenses will be increased by 5 percentage points on the basis of the above payment ratio.

The above information was collected from the Internet. For details, please consult Qingdao Social Security Center.

Qingdao medical insurance reimbursement scope

Scope of reimbursement for residents' medical insurance:

1. Medical expenses for serious illness hospitalization and serious illness outpatient service;

2. General outpatient medical expenses for the elderly;

3. Outpatient medical expenses for accidental injuries of children and college students;

4. Meet the requirements of drug procurement expenses;

5. Hospitalization expenses that meet the requirements.