Jiangxi outpatient reimbursement starting line

The starting line standards for outpatient reimbursement are as follows:

1. The starting line standard is set at 100 yuan;

2. The annual outpatient reimbursement limit for participants under 45 years old is 2,000 yuan, and the reimbursement rate is 50 percent;

3. The annual outpatient reimbursement limit for participants 45 years old and above is 3,000 yuan, and the reimbursement rate is 50 percent;

4. The annual outpatient reimbursement limit for retirees is $3,500, and the Medicare reimbursement rate is 60 percent.

Social security reimbursement policy:

1. Scope of reimbursement: Compliance medical expenses including medicine, diagnosis and treatment, examination, etc.

2. Reimbursement rate: The reimbursement rate may be different according to different regions and social security policies;

3. Reimbursement process: Usually, it is necessary to submit the relevant medical expense vouchers, medical insurance cards and other documents;

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4. Reimbursement limit: Each year, there is a certain reimbursement ceiling based on the individual's social security contributions and policy regulations;

5. Reimbursement for special illnesses: For major diseases or special illnesses, the social security system may provide a higher reimbursement rate or special financial support.

In summary, outpatient reimbursement starts at $100, with an annual limit of $2,000 and a reimbursement rate of 50 percent for participants under 45 years old, $3,000 and a reimbursement rate of 50 percent for those 45 years old and older, and an annual limit of $3,500 and a reimbursement rate of 60 percent for retirees.

Legal basis:

"Interim Measures for Supplementary Medical Insurance for Urban Residents with Major Diseases in Jiangxi Province"

Article 10

The medical expenses incurred by the insured residents that exceed the annual maximum payment limit of the integrated fund of the basic medical insurance for urban residents and are in conformity with the scope of the payment of the basic medical insurance for urban residents are paid for by the residents' supplemental medical insurance in accordance with no less than the following regulations Standard payment: medical institutions Payment standard level 1 90% level 2 85% level 3 80% referral 70%

The People's Republic of China Social Insurance Law

Article 28

Medical expenses in line with the basic medical insurance drug catalog, diagnostic and treatment items, standards of medical service facilities, as well as those for emergency and rescue, shall be paid from the basic medical insurance fund in accordance with the state regulations. shall be paid from the basic medical insurance fund.

Article 29

The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administrative organization and the medical institutions and drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.