What is the reimbursement rate of school medical insurance?

The medical expenses incurred by the insured students in the first-class medical institutions and pharmacies designated by medical insurance within the policy scope will be reimbursed by 500-3000 yuan. The focus of residents' medical insurance is to ensure serious illness. Students' medical insurance benefits refer to the high-level medical insurance benefits of adult residents. 500 yuan above to 6.5438+0.8 million yuan, 80% of the first-class hospitals, 75% of the second-class hospitals and 65% of the third-class hospitals. In addition, insured students also enjoy reimbursement of residents' serious illness insurance.

1, outpatient reimbursement

1) 35% of insufficient medical expenses 1000 yuan (excluding);

2) 1 1,000 yuan (inclusive) to 5000 yuan (exclusive) 45% of the medical expenses;

3) 55% of the medical expenses ranging from 5000 yuan (inclusive) to 10000 yuan (exclusive);

4)/kloc-65% of medical expenses above RMB 0/0000 (inclusive).

2, hospitalization reimbursement

1) If the medical expenses are less than 10000 yuan (excluding), the reimbursement rates in tertiary, secondary and primary medical institutions are 55%, 65% and 75% respectively;

2) For the portion of medical expenses 1 10,000 yuan (inclusive) to 20,000 yuan (exclusive), the proportion of reimbursement for medical treatment in tertiary, secondary and primary medical institutions is 60%, 70% and 80% respectively;

3) The proportion of reimbursement for medical expenses above 20,000 yuan in tertiary, secondary and primary medical institutions is 65%, 75% and 85% respectively.

According to the "Guiding Opinions of the State Council on Launching the Pilot Project of Basic Medical Insurance for Urban Residents":

(1) Insurance coverage. Full-time undergraduate and full-time graduate students who receive general higher education in various full-time ordinary colleges and universities (including private colleges and universities) and research institutes.

(2) protection mode. College students' hospitalization and serious illness outpatient medical treatment are solved by participating in the basic medical insurance for urban residents where the school is located according to the principle of territoriality. College students pay fees according to local regulations and enjoy corresponding treatment, which is not lower than that of local urban residents. At the same time, in accordance with the existing regulations, continue to do a good job in the daily medical work of college students, so as to facilitate their timely medical treatment.

Encourage college students to participate in basic medical insurance on a voluntary basis and improve the level of medical security by participating in commercial medical insurance.

(3) fund raising. The individual payment standards and government subsidy standards for college students to participate in the basic medical insurance for urban residents shall be implemented in accordance with the corresponding standards for local primary and secondary school students to participate in the basic medical insurance for urban residents.

In principle, individual contributions are borne by college students themselves and their families, and colleges and universities with conditions can subsidize their contributions. The government subsidy funds required for college students to participate in insurance shall be arranged by the finance at the same level according to the affiliation of colleges and universities.

The central government grants subsidies to local college students in accordance with the basic medical insurance subsidy measures for urban residents. The daily medical expenses of college students shall continue to be subsidized by the finance at the same level according to the affiliation of colleges and universities.

All localities should take measures to subsidize the basic medical insurance premiums that students from poor families should pay and the medical expenses that should be borne by them according to regulations through various channels, such as the medical assistance system, the financial aid system for students from poor families and social charitable donations, so as to effectively reduce the burden of medical expenses for students from poor families.

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;

(3) borne by public health;

(4) Go abroad for medical treatment.