How much can the social security card be reimbursed?

Question 1: How many employees and retirees can apply for medical insurance reimbursement? Outpatient treatment in line with the provisions of some serious medical expenses, paid by the overall fund according to the following proportion.

Pay, but individuals also have to bear a certain proportion:

(1) 80% of employees' medical treatment is paid by the overall fund and 20% by individuals;

(2) For retirees seeking medical treatment, the overall fund pays 85%, and the individual pays 15%.

Employees and retirees are hospitalized, rescued or treated for some major diseases in an insurance year.

When the accumulated medical expenses exceed the "top line" of the overall fund, the commercial insurance company will calculate them in sections and pay them cumulatively.

Responsible for claims settlement, but individuals also have to bear a certain proportion of expenses, specifically:.

(! ) 30,000 yuan to 654.38+10,000 yuan (inclusive) for medical expenses, 94% for large medical insurance premiums, and 6% for individuals;

(2) For medical expenses ranging from 6,543,800 yuan to 200,000 yuan (inclusive), 96% of the large medical insurance premium is paid, and 4% is paid by the individual;

(3) For medical expenses of more than 200,000 yuan, 98% is paid for large medical insurance premiums, and 2% is paid for individuals.

In a year, the highest proportion of large medical insurance premiums is 300,000 yuan per person.

In addition, in an insurance year, the hospitalization, emergency rescue and outpatient treatment of employees and retirees meet the requirements.

Serious diseases, medical expenses paid by individuals within 30 thousand yuan (excluding the standard medical expenses paid by individuals and not.

In line with the provisions of the basic medical insurance medical expenses) accumulated more than 4000 yuan, by the commercial insurance company to give a one-time 1000.

Yuan subsidy.

Question 2: How much can the social security card be reimbursed for medical treatment? Different diseases, different treatments, drugs, outpatient or hospitalization, etc. , are very general and difficult to answer.

Question 3: How many medical insurance cards can be reimbursed by medical insurance?

First, outpatient and emergency expenses.

1. The medical expenses above 1800 yuan can only be reimbursed after the on-the-job employees see a doctor in the emergency department of the hospital, and the reimbursement rate is 50%.

2. Retirees under the age of 70,1.Expenses above 300 yuan can be reimbursed, and the reimbursement rate is 70%.

3. Retirees over 70 years old,1.Expenses above 300 yuan can be reimbursed by 80%.

Second, the hospitalization expenses.

The maximum annual payment limit (hospitalization expenses) of the basic medical insurance pooling fund is currently 70,000 yuan.

1, the standard of hospitalization reimbursement is related to the level of the hospital where the insured person is located. If you live in a tertiary hospital, the employee pays 15%, which is 85% of the reimbursement, from the minimum threshold to 30,000 yuan.

2, 30,000 yuan to 40,000 yuan, the employee's individual contribution 10%, 90% reimbursement;

3, more than 40000 yuan to the maximum payment limit, 95% can be reimbursed, employees only need to pay 5%.

4. The individual contribution ratio of retirees is 60% of the on-the-job (i.e. the above) employees, but all below the threshold is paid by individuals.

Three, designated hospitals and retail pharmacies

Reimbursement scope of designated hospitals and retail pharmacies: The insured can only be reimbursed if he visits four designated medical institutions (except emergency) or designated Chinese medicine and specialties (including stomatological hospitals, maternity hospitals, cancer hospitals, etc.). ) and 1 1 Class A medical institutions.

Question 4: How much can the company social security card report for illness treatment? Medical insurance reimbursement needs to be submitted to the local medical insurance management center or the medical insurance checkout window of designated medical institutions. Procedures include: my ID card, medical insurance card, original invoice, drug list, medical record book, list, admission/discharge certificate and other materials. Medical insurance reimbursement is carried out in proportion, generally floating around 70%. The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors. For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs. Total medical expenses160,000 yuan, and the reimbursement formula is: (160,000-self-paid amount-self-paid drugs) *70%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed. In addition, it is also important to go to designated medical institutions for medical treatment. Of course, this is also implemented according to different systems in each region. For example, medical reimbursement in some places can be as high as 90%. Please consult the local department for details. Oh, also, it seems that medical insurance benefits have to be paid first, and they can only be reimbursed with receipts after they are completed.

Hope to adopt

Question 5: How much can I reimburse for my own social security card? Generally speaking, you can't guarantee how much you will spend. The personal account balance on the medical insurance card, except the individual payment, is included in the social security payment base 1. 1~ 1.7% according to the age of the insured, and is generally not reimbursed separately. Except those who enjoy the treatment of civil servants (75% of social security on-the-job reimbursement and 80% of retirement reimbursement exceed the annual card outpatient pharmacy consumption1200); In addition to the unit has other benefits (such as district-level civil servants, teachers, etc. , and reimbursed by the document unit).

Question 6: How much can social security be reimbursed? How much can medical insurance be reimbursed? Whether social security can be reimbursed together is a general term for social insurance, including medical insurance, so only medical insurance can be reimbursed.

Question 7: How much can the medical insurance card be reimbursed in a few months? Newly insured employees (including those who have been re-insured for more than 1 year after interruption of payment) shall participate in the basic medical insurance according to law, and if the payment reaches 1 year (excluding the overdue period), they shall enjoy the basic medical insurance benefits in accordance with the regulations; Over six months but less than one year, according to 50%; If it is less than six months, it will not be paid.

Proportion of medical insurance reimbursement:

1, prerequisite: Qifubiaozhun to the maximum payment limit of the basic medical insurance pooling fund.

2. The proportion of employees' contributions is 93% in community health centers, 88% in first-class hospitals, 86% in second-class hospitals and 84% in third-class hospitals.

3. The payment ratio of retirees is 96.5% in community health centers, 94% in first-class hospitals, 93% in second-class hospitals and 92% in third-class hospitals.

4. The rest expenses shall be borne by the individual.

Question 8: How much can social security be reimbursed? If it is basic medical care, some cities can directly settle accounts with the hospital and hand over the social security card to the hospital, but some inspection and medicine fees cannot be reimbursed, depending on the reimbursement list of the local social security bureau; Some cities go to the Social Security Bureau for reimbursement with the medical certificate from the hospital. Just take the medical record, examination fee and medicine fee to the social security bureau.

The reimbursement amount varies from place to place. Please consult the local social security bureau for details.

Question 9: How much can employees be reimbursed for medical insurance hospitalization? Among the three kinds of insurance, social medical insurance is the most. Because of its high financing ratio, the treatment level is naturally high. Due to the great differences in different places, the proportion of reimbursement of medical expenses within the scope of hospitalization medical insurance varies with different hospital levels, generally between 70% and 95%. The reimbursement of medical expenses is faster. As long as your reimbursement documents are accepted by the medical insurance department, the money must be transferred to your personal account within 20-30 working days. If it is not sent to the medical insurance department in the hands of the unit, it is hard to say.

Question 10: Can medical insurance be reimbursed for the normal experience of more than 2,000 yuan? 1. There will be a medical insurance card or social security card after participating in medical insurance. If you go to the clinic, you can pay directly by swiping the medical insurance card. The amount in the card is recorded by social security every month. There is no proportion in this. As long as the drugs prescribed by doctors are within the scope of social security payment, social security can pay, but it does not rule out that some drugs need to be paid at their own expense. 2. If you are hospitalized, show your medical insurance card or social security card before hospitalization registration. During hospitalization, doctors will try to prescribe drugs within the scope of social security for treatment. When you check out, the hospital toll office will give you a certain proportion of reimbursement according to the hospital level. (For example, the hospitalization expenses are 3,000 yuan, except for self-funded items, the rest of the medical expenses are reimbursed according to the hospital level, 70% in the third-class first-class hospital and 80% in the second-class first-class hospital. The regulations vary from province to province, depending on the specific regional regulations. 3. reimbursement for hospitalization, you don't need to provide other information, just provide medical insurance card or social security card and. Medical insurance includes basic medical care and hospitalization. The basic medical treatment = outpatient medical treatment+hospitalization medical treatment, and hospitalization medical treatment refers to a single hospitalization. Outpatient service is the kind that goes directly to the hospital to take medicine home after hanging up the number, and hospitalization is hospitalization. The two are separate.