Proportion of civil servants' medical insurance reimbursement in Beijing

The reimbursement rate of civil servants' medical insurance in Beijing is as follows:

1, the reimbursement rate of in-service workers' hospitals is over 70%, and that of retirees is over 85%; The reimbursement rate of community health institutions is 90%, and the outpatient capping line is 20,000 yuan;

2. In-service employees' hospitalization reimbursement rate is above 85%, retirees' hospitalization reimbursement rate is above 90%, reaching 99. 1%, and the maximum hospitalization limit is 500,000 yuan;

3. On-the-job employee outpatient deductible line 1.800 yuan, inpatient deductible line for the first time 1.300 yuan, and 650 yuan for the second time and later;

4. According to different levels of hospitals, the proportion of reimbursement for hospitalization is 90% in first-class hospitals, 87% in second-class hospitals and 85% in third-class hospitals. The accumulated hospitalization reimbursement limit is 300,000 yuan.

Calculation method of Medicaid for civil servants;

1. Reimbursement ratio of basic medical insurance: According to the policies of different regions, the reimbursement ratio of basic medical insurance is usually between 50% and 90%;

2. The amount of medical subsidies for civil servants: after the reimbursement of basic medical insurance, civil servants can also enjoy additional medical subsidies, and the amount of subsidies is determined according to the rank and working years of civil servants;

3. Reimbursement process: Civil servants need to be reimbursed through basic medical insurance first, and then apply for Medicaid with relevant supporting materials;

4. Reimbursement scope: usually including outpatient expenses, hospitalization expenses, medicine expenses, etc. , but the specific reimbursable items need to refer to local policies;

5. Annual capping line: Medicaid for civil servants usually has an annual reimbursement capping line, and the excess will not be reimbursed.

To sum up, the reimbursement rate of civil servants' medical insurance in Beijing is relatively high, including the reimbursement rate of on-the-job employees and retirees, as well as the outpatient capping line and hospitalization capping line of community health institutions. In addition, there are outpatient and inpatient deductible lines and hospitalization reimbursement rates, which vary according to different hospital grades.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.

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.