What is the proportion of medical insurance reimbursement in different places in Henan Province?

The reimbursement ratio of medical insurance in different places in Henan Province is as follows:

1, outpatient reimbursement ratio: the medical insurance fund pays 50%, and the annual payment limit is 500 yuan;

2. Hospitalization reimbursement ratio: after the hospitalization expenses are deducted from the self-funded items, the reimbursement ratio is above the deductible line to 4,000 yuan, and the medical insurance fund pays 80%; 4000 yuan to 10000 yuan, and the proportion of medical insurance fund payment is 85%; 10000 yuan to 20000 yuan, and the medical insurance fund pays 90%; 20,000 yuan to the maximum payment limit, and the medical insurance fund payment ratio is 95%;

3. Proportion of outpatient reimbursement for chronic diseases: the proportion of medical insurance fund payment is 60%, and the annual payment limit is 3,000 yuan.

The information required for medical insurance in different places is as follows:

1, ID card: valid ID cards such as ID cards and passports are required for medical insurance in different places;

2. Medical insurance card: when handling the medical insurance transfer procedures in different places, you need to submit it with your own medical insurance card;

3. Social security certificate: it is necessary to provide the social security certificate issued by the social security bureau of the original insured place to prove that the original insured place has participated in social security and paid social insurance premiums;

4. Case certificate: Some areas may need to provide case certificates to prove the reasons for the need for medical treatment in different places.

The reimbursement process after individuals pay medical insurance is generally as follows:

1. See a doctor: When you see a doctor or buy medicine in a medical institution, you need to show your medical insurance card, ID card and other relevant documents;

2. Preparation of reimbursement materials: after seeing a doctor, you need to go to a medical institution to obtain medical records, doctor's orders, prescriptions, receipts and other related materials, and fill in the relevant reimbursement application form;

3. Submit reimbursement application: submit the prepared reimbursement materials and application forms to the local social security bureau or medical insurance center for reimbursement application. You can also choose to apply for reimbursement online;

4. Review the reimbursement application: the local social security bureau or medical insurance center will review the submitted reimbursement application, and after the approval, the reimbursement will be credited to the personal bank account.

To sum up, the medical insurance policy and reimbursement ratio may be different in different regions, and the specific situation should be subject to local policies. At the same time, the scope and amount of medical insurance fund payment are also affected by different policies, and the specific reimbursement ratio and amount will also change due to different medical projects.

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.