How much is the reimbursement for cross-provincial medical insurance in different places?

Inter-provincial medical insurance reimbursement is as follows:

1. Basic medical insurance for urban workers: for medical treatment in a specified medical institution, the reimbursement rate is the payment standard of basic medical insurance in the place where the designated medical institution is located (hereinafter referred to as "payment standard of designated medical institution"). For medical treatment in non-designated medical institutions, the reimbursement rate is 70% of the payment standard of designated medical institutions;

2. Basic medical insurance for urban and rural residents: The reimbursement rate for medical treatment in designated medical institutions is the payment standard of designated medical institutions. For medical treatment in non-designated medical institutions, the reimbursement rate is 60% of the payment standard of designated medical institutions;

3. New rural cooperative medical care: medical treatment in a prescribed medical institution, and the reimbursement ratio is the payment standard of the designated medical institution. For medical treatment in non-designated medical institutions, the reimbursement rate is 70% of the payment standard of designated medical institutions.

The proportion of medical insurance reimbursement is as follows:

1, students and children. In a settlement year, medical expenses below RMB 6,543,800+0,800 yuan that meet the scope of reimbursement occurred. The threshold for tertiary hospitals is 500 yuan, and the reimbursement ratio is 55%; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no qifubiaozhun for first-class hospitals, and the reimbursement rate is 65%;

They are old people in their seventies. In a settlement year, medical expenses below RMB 6,543,800+that meet the scope of reimbursement occur, and the threshold for tertiary hospitals is 500 yuan, and the reimbursement ratio is 50%; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no qifubiaozhun for first-class hospitals, and the reimbursement rate is 65%;

They are residents of other towns. In a settlement year, medical expenses below RMB 6,543,800+that meet the scope of reimbursement occur, and the threshold for tertiary hospitals is 500 yuan, and the reimbursement ratio is 50%; The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.

The medical insurance reimbursement process is as follows:

1. Hospitalization medical expenses shall be paid by individuals in advance. After discharge, medical insurance card, ID card, outpatient medical record, discharge summary, general list of expenses (detailed list of expenses), disease diagnosis certificate, valid bill (original invoice), doctor's advice, copy of the first page of medical record, certificate issued by the school, certificate of transfer to hospital and relevant certificate issued by the college shall be provided. For medical treatment in different hospitals, materials from different hospitals should be provided; In the same hospital, according to the different hospitalization time (before the expenses are written off, such as being treated in the same hospital after discharge), materials of hospitalization in different periods should also be provided;

2, after the opening of the credit card settlement function, the student himself or his guardian or client shall, within three days of hospitalization, go to the medical window of the service hall of the municipal medical insurance center with the student ID card, the provincial social security card, the medical record of the hospital, the certificate of disease diagnosis and the certificate issued by the college;

3. Treatment of emergency expenses of non-designated medical institutions: within 3-5 working days of emergency, first contact or entrust others to register with the municipal medical insurance management center through the student medical insurance management center of our hospital, and the medical expenses will be paid in advance by myself. At the time of reimbursement, apply for reimbursement to the municipal medical insurance center with the above reimbursement materials (non-medical insurance designated hospitals or clinics cannot be reimbursed).

To sum up, the reimbursement rate of medical insurance in different provinces is calculated according to the payment standard of designated medical institutions, so the reimbursement rate in different regions may be different. At the same time, the reimbursement ratio is also limited by the total medical expenses and the personal payment limit. Therefore, before seeking medical treatment in different places, it is recommended to consult the local medical insurance institutions in advance to understand the reimbursement ratio and reimbursement conditions.

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.