How much is the reimbursement from Dongguan Auxiliary Hospital?

Dongguan Auxiliary Hospital reimburses 35% to 50%.

Go directly to the auxiliary hospital for medical treatment without referral, with 35% reimbursement in tertiary hospitals and 50% reimbursement in secondary and below hospitals. The annual limit is 65438+ 0% of the average annual salary of urban workers in this city in the previous year.

Medical insurance reimbursement scope:

1. Insurance liability for hospitalization medical expenses within the scope of medical insurance, as well as some expenses in the medical insurance catalogue that are still borne by individuals after being reimbursed by basic medical insurance, serious illness insurance and medical assistance. , shall bear the liability for compensation within the agreed scope of insurance liability. 1 10,000 insured amount,10.5 million free of compensation, the reimbursement rate is 80%, and the reimbursement rate for continuous participation is increased to 85%;

2. The insurance liability of hospitalization medical expenses outside medical insurance coverage, as well as the part that is still borne by individuals after the expenses outside the medical insurance catalogue are reimbursed by basic medical insurance, serious illness insurance and medical assistance, shall be liable for compensation within the agreed scope of insurance liability. 1 10,000 insured amount,1.8,000 free of compensation, the reimbursement rate is 60%, and the reimbursement rate for continuous participation is increased to 65%;

3, outpatient specific high drug costs insurance liability, in designated hospitals, designated pharmacies, drug costs borne by individuals, within the agreed scope of insurance liability, bear the liability for compensation. 700,000 insured amount, 26 kinds of drugs, and 20,000 yuan shared with the insurance responsibility of outpatient drugs/hospitalization medical insurance expenses for rare diseases, with a compensation ratio of 80%;

4. Designate the insurance liability of outpatient drugs for rare diseases/hospitalization medical insurance expenses, and pay part of the drug expenses paid by individuals in designated hospitals and pharmacies within the agreed scope of insurance liability. 300,000 insured amount, 12 drugs, sharing 20,000 yuan with the insurance responsibility of outpatient specific high drug expenses, and the reimbursement ratio is 70%.

To sum up, those who seek medical treatment in medical institutions in this city due to outpatient first aid and rescue can be directly reimbursed at 75% without going through the referral procedures. Those who sign a family doctor and effectively perform the contract, regardless of the type of institution or the annual quota, will rise by 5%.

Legal basis:

Article 2 of People's Republic of China (PRC) Insurance Law

The term "insurance" as mentioned in this Law refers to the commercial insurance behavior in which the applicant pays the insurance premium to the insurer according to the contract, and when the insured dies, suffers from disability, illness or reaches the age and time limit agreed in the contract, the insurer shall be liable for the property losses caused by the possible accidents agreed in the contract.

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This Law is applicable to insurance activities in People's Republic of China (PRC).

Article 5

The parties to insurance activities shall exercise their rights and perform their obligations in accordance with the principle of good faith.