Tianjin medical insurance reimbursement ratio 2023

In 2023, the proportion of medical insurance reimbursement in Tianjin was 55% to 95%.

The reimbursement rate for employees, retirees and first-class designated medical institutions is 75%. Two designated medical institutions, the reimbursement rate is 65%; Three designated medical institutions, the reimbursement rate is 55%. The reimbursement rate of old workers and model workers is 95%. After signing a family doctor, you can see a doctor in a designated medical institution according to the relevant regulations, and you can increase the proportion of reimbursement and the limit of expenses.

Hospitalization or two or more special outpatient diseases, according to the principle of high priority with deductible. Outpatient, inpatient and outpatient medical expenses that meet the conditions of medical insurance reimbursement can be reimbursed by employee's serious illness insurance if the personal burden exceeds Qifubiaozhun after medical reimbursement. For medical assistance recipients, the deductible line is reduced by 50% on the basis of the general population, the reimbursement ratio is increased by 5 percentage points, and the top line is cancelled.

Medical insurance reimbursement conditions

1. Among the medical expenses that the insured meets the scope of payment of basic medical insurance, the part that is higher than the minimum payment standard of social medical pooling fund and lower than the maximum payment limit shall be paid by social medical pooling fund in a unified proportion.

2, the insured must go to the basic medical insurance designated medical institutions, or to the designated retail pharmacies determined by the social insurance institutions with medical prescriptions issued by doctors in designated hospitals.

3. The medical expenses incurred by the insured in the process of medical treatment must conform to the scope and payment standards of the basic medical insurance drug list, medical treatment items and medical service facilities standards, and can be paid by the basic medical insurance fund according to the regulations.