What is the time limit for social security medical reimbursement?

We usually buy some insurance in our life, just to avoid some unexpected troubles. Among these insurances, there is medical insurance. So when we need to use medical insurance for reimbursement, how long is the reimbursement period? Let's take a look at how long the social security medical reimbursement period is. 1. What is the time limit for social security medical reimbursement? Generally speaking, the period of reimbursement is one year. Once this one-year time limit has passed, it is impossible to go to the designated place for reimbursement. So as long as it is reimbursed within one year after discharge. Once this period has passed, the insurance will be renewed. In addition, in some remote places, rural medical insurance is more difficult to implement, and farmers often have problems that they can't find a place to reimburse, and the expenses for reimbursement are less than the prescribed ones. All kinds of situations show that this system in China needs the continuous improvement of relevant departments. Regarding the local medical insurance reimbursement policy, you can consult the local medical insurance bureau or social security bureau in detail. You can also call the social security number 12333 if you have any questions!

Second, how many employees are reimbursed by medical insurance? After seeing a doctor in the emergency department of the hospital, the medical expenses of more than 2,000 yuan can be reimbursed, and the reimbursement ratio is 50%. For retirees under the age of 70, the expenses above 1300 yuan can be reimbursed, and the reimbursement rate is 70%.

For retirees over 70 years old,180% of the expenses above 300 yuan can be reimbursed. No matter what kind of people, the maximum payment limit for outpatient and emergency medical expenses is 20 thousand yuan. For example, if you are an on-the-job employee, and the outpatient medical expenses are 2,500 yuan, then 500 yuan can reimburse 50%, that is, 250 yuan.

3. What is the proportion of medical insurance reimbursement? Almost everyone knows that getting medical insurance does not mean that all medical expenses can be reimbursed, but there are not many details about the specific reimbursement amount.

The relevant person in charge of the Medical Insurance Department of Dongcheng District Labor and Social Security Bureau told the reporter that after getting medical insurance, if they are on-the-job employees, after seeing a doctor in the emergency department of the hospital, the medical expenses of more than 2,000 yuan can only be reimbursed, and the reimbursement ratio is 50%. For retirees under the age of 70, the expenses above 1300 yuan can be reimbursed, and the reimbursement rate is 70%. For retirees over 70 years old,180% of the expenses above 300 yuan can be reimbursed.

No matter what kind of people, the maximum payment limit for outpatient and emergency medical expenses is 20 thousand yuan. For example, if you are an on-the-job employee, and the outpatient medical expenses are 2,500 yuan, then this 500 yuan can be reimbursed 50%, that is, 250 yuan.

In case of hospitalization expenses, employees and retirees should pay the minimum amount 1300 yuan when using the basic medical insurance for the first time in a year. And the second and subsequent hospitalization medical expenses, Qifubiaozhun is determined by 50%, which is 650 yuan. The maximum annual payment limit (hospitalization expenses) of the basic medical insurance pooling fund is currently 70,000 yuan.

The reimbursement standard for hospitalization is related to the level of the hospital where the insured person is located. For example, in a tertiary hospital, employees have to pay 15%, that is, 85%, from the threshold to 30,000 yuan. The expenses of 30,000-40,000 yuan shall be paid by employees themselves 10%, and 90% shall be reimbursed; If the expenses exceed 40,000 yuan to the maximum payment limit, 95% can be reimbursed, and employees only need to pay 5%. Retirees pay 60% of the on-the-job employees, but all below the minimum threshold are paid by individuals.

Almost everyone who goes to the hospital will encounter this situation. When registering and prescribing drugs, medical staff always ask patients whether they are insured or free of charge or at their own expense. Is it necessary to "look at people and eat vegetables" to see a doctor and take medicine? An ophthalmologist in a hospital who asked not to be named told reporters that generally speaking, the main reason for asking this question is that medical insurance participants can only be reimbursed if they consume drugs in the medical insurance catalogue. In the case of similar curative effect, try to choose drugs that can reimburse the insured. For out-of-pocket patients, there are more choices.

So, how are the drugs in the medical insurance catalogue determined? The reporter learned from the Medical Insurance Department of the Municipal Labor and Social Security Bureau that the drugs in Beijing's basic medical insurance catalogue are mainly drugs published by the Ministry of Labor, and Beijing has the right to organize experts to make adjustments according to the incidence of the city within the range of 15%. Generally speaking, the principle of selection is safety, reliability, reasonable cost and clinical necessity, while some drugs with high cost, big side effects and little clinical application are not listed in the catalogue, so patients can only use them at their own expense.

The relevant person in charge of the Medical Insurance Department of Dongcheng District Labor Insurance Bureau told the reporter that according to the relevant regulations, employees pay the basic medical insurance premium at 2% of their average salary in the previous year. After the insured person joins the medical insurance, he will get a current passbook of Bank of Beijing, and all the 2% basic medical insurance paid by the individual will be credited to his personal account. Generally, the money for going to the clinic to see a minor illness is from the personal account, and the money in the personal account can be freely controlled by the individual. In principle, it is used to pay daily small medical expenses and medical expenses that should be paid by individuals according to regulations. Its interest is calculated according to the deposit rate of residents in the same period, but the state does not levy interest tax on the deposits in the account. Therefore, the insured can only withdraw money from this account, not save money.