What is the reimbursement ratio of rural social security and medical insurance in Guangzhou?

1. On-the-job employees: Grade-III and Grade-A hospitals, with 90% reimbursement from the overall fund and individual paying10%; Secondary hospitals, 85% of the overall fund reimbursement, individual pays15%; In tertiary hospitals, 80% is reimbursed from the overall fund and 20% is paid by individuals.

2. Retirees: first-class hospitals, with 93% reimbursement from the overall fund and 7% paid by individuals; The secondary hospitals reimbursed 89.5% from the overall fund, and the individual paid10.5%; 86% of the hospitals in Grade III and Grade A are reimbursed from the overall fund, and 14% are paid by individuals.

3. Migrant workers (migrant workers buy foreign accounts in Guangzhou with medical insurance): First-class and first-class hospitals, with 72% reimbursement from the overall fund and 28% paid by individuals; Secondary hospitals, 68% of the overall fund reimbursement, and 32% of the individual pays; In a third-class first-class hospital, 64% is reimbursed from the overall fund and 36% is paid by the individual.

Remarks: (1) On-the-job employees refer to those who have purchased social security for employees in Guangzhou.

(2) First-class hospitals refer to community hospitals and relatively low-level hospitals. Tertiary hospitals refer to national tertiary hospitals, such as Guangdong Provincial People's Hospital and First Hospital of Traditional Chinese Medicine.

(3) The Qifubiaozhun of the overall fund means that when the hospitalization expenses exceed the above standards, the excess can be reimbursed.

(For example, an employee with a Guangzhou hukou is ill and hospitalized in Guangdong Provincial People's Hospital (3A hospital), with a total cost of 3,000 yuan. The minimum hospitalization deductible line of 3A hospitals is 1.600 yuan, so the expenses exceeding the deductible line are 1.400 yuan, of which 80% are directly reimbursed by the overall fund, that is,1.654,38+0.20 yuan, and the personal expenses are 1.600 yuan plus 280 yuan, that is, the total expenses.

Proportion of outpatient reimbursement in Guangzhou (compared with the proportion of medical insurance reimbursement in Guangzhou):

General outpatient treatment: 1 employee (who has purchased social security for Guangzhou employees) and retirees, 65% is reimbursed by community hospitals and 50% by other medical institutions.

2. For flexible employees (those who go to the Social Security Bureau to purchase social security by their own household registration in Guangzhou) and migrant workers (those who purchase medical insurance for migrant workers), 55% will be reimbursed by community hospitals and 40% by other medical institutions.

Note: The maximum monthly reimbursement amount is 300 yuan/person, which is valid in the current month and is not rolled over or accumulated.

Label: social security knowledge, medical insurance handling guide

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.