Dongguan second grade medical insurance how much amount can be reimbursed

Dongguan second-grade health insurance is hospitalization health insurance, outpatient reimbursement of 1000 yuan per year, hospitalization, the basic reimbursement of 70% -80% in the hospitalization procedures before the presentation of social security and fill in up, the discharge settlement will be directly subtracted from the reimbursable portion of the cost. If the health insurance is interrupted for more than 3 months, the contribution period is recalculated.

According to the Dongguan health insurance management methods, the Dongguan second-grade health insurance reimbursement conditions are as follows:

1, the insured person must be in the Dongguan City administrative area to seek medical treatment or purchase drugs;

2, the insured person must be in the prescribed medical institutions to seek medical treatment or purchase drugs, and the medical institutions must have the relevant qualifications and health insurance designated qualifications;

3, the insured person must be in the Medical institutions for diagnosis, treatment or purchase of medicines in accordance with the national and local medical insurance catalog;

4. Participants must have a medical insurance e-voucher or medical insurance card and make reimbursement through the medical insurance e-settlement or manual settlement within the stipulated period of time.

In summary, the specific reimbursement rates and limits and other conditions vary according to different health insurance policies and individual participation, the specific details can be consulted with the local health insurance department.

Legal basis:

Article 25 of the Social Insurance Law of the People's Republic of China

The state establishes and improves the basic medical insurance system for urban residents. Basic medical insurance for urban residents combines individual contributions and government subsidies. The government shall subsidize the portion of individual contributions required by persons enjoying the minimum subsistence guarantee, persons with disabilities who have lost the ability to work, and elderly persons over 60 years of age and minors from low-income families.

Article 28

Medical expenses that conform to the basic medical insurance drug catalog, diagnostic and therapeutic items, and medical service facility standards, as well as those for emergencies and resuscitations, shall be paid out of the basic medical insurance fund in accordance with state regulations.

Article 30

The following medical expenses shall not be included in the scope of payment by the basic medical insurance fund:

(1) those that should be paid from the Workers' Compensation Insurance Fund;

(2) those that should be borne by a third person;

(3) those that should be borne by the public ****health;

(4) those that are sought outside the country. If the medical expenses should be borne by a third person according to law, and the third person does not pay or the third person cannot be identified, the basic medical insurance fund will pay first. The basic medical insurance fund shall have the right to recover from the third party after the first payment.