How much can Chaling rural medical insurance be reimbursed in 2022?

Proportion of reimbursement for hospitalization in rural medical insurance: 60% in town health centers; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.

Legal analysis: the proportion of reimbursement for hospitalization in rural medical insurance: 60% for reimbursement in town hospitals; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.

Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC), the following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.

Reimbursement scope: It is understood that after hospitalization, physiotherapy fees, operation fees, examination fees (electrocardiogram, X-ray, CT, nuclear magnetic resonance) and laboratory fees are included. If the patient is over 60 years old, the state will subsidize the hospitalization expenses per day 10 yuan, and the maximum subsidy will be to 200 yuan. If you seek medical treatment locally, you can reimburse directly when you leave the hospital, and you only need to pay for the hospitalization expenses yourself. If the hospital can't directly reimburse, it needs to bring ID card, household registration book, case, hospitalization record and medical expense list to the local medical insurance center to apply for reimbursement. If you really go to a different place for medical treatment, you must not only bring the above materials, but also provide proof of work before you can be reimbursed.

Medical insurance reimbursement rules:

1, reimbursement can only be made if the continuous payment time reaches the standard. Medical insurance is not reimbursed immediately after insurance. Employee medical insurance is generally insured in the current month and reimbursed next month. If it has been paid for a period of time before, it may take three to six months in some areas to be reimbursed. Flexible employees must pay for medical insurance for 6 months.

2. Reimbursement can only be made if the deductible is exceeded. Medical insurance reimbursement has a deductible line and a capping line, and medical expenses can only be reimbursed if they exceed the deductible line and are lower than the capping line; Medical insurance reimbursement is also proportional reimbursement, and the rest should be reimbursed at their own expense. Medical insurance drugs can only be reimbursed in the medical insurance catalogue.

3. Reimbursement should not be overtime. When you leave the hospital, you must remember to bring your social security card and medical insurance card to settle the expenses; If you can't settle the bill immediately, you can pay in advance, and then submit the medical expenses to the medical insurance department manually with the documents and vouchers. In addition, there is a time limit for reimbursement, and you have to bear it yourself after the time limit.