Proportion of medical insurance reimbursement for employees in Shijiazhuang City

Proportion of medical insurance reimbursement for employees in Shijiazhuang:

1, outpatient and emergency medical expenses: the accumulated medical expenses of employees in medical insurance coverage this year (1 to February 3 1 day 1 day) exceeded 2,000 yuan;

2. Settlement ratio: 50% of the part of the dispatched personnel above 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan. In an insurance year, if the general outpatient expenses of insured residents in designated medical institutions are within 100 yuan (inclusive), the residents' medical insurance fund will pay 30% and individuals will pay 70%; Personal consumption exceeds 100 yuan. In other words, the outpatient service in Gubao can reimburse 30 yuan money at most. For example, for the first time, 60 yuan paid 18 yuan, and for the second time, 80 yuan only paid 12 yuan.

Medical insurance reimbursement process:

1. The agent submits the reimbursement documents and other materials to the social security agency for acceptance;

2. After receiving the application materials, the accepting department shall review, settle accounts and pay;

3. If the social security agency approves the application, the applicant will be reimbursed after receiving the "Social Medical Insurance Medical Expense Reimbursement Form". The medical insurance reimbursement process is relatively simple, and now it has also opened cross-regional medical insurance reimbursement, so you don't have to go back and forth for medical treatment in different places.

Legal basis: Article 2 of People's Republic of China (PRC) Social Insurance Law.

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to get material help from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.