Proportion of hospitalization reimbursement for medical insurance in Jinan in 2022

According to the level of urban economic development, Jinan municipal government divides the proportion of medical insurance reimbursement for urban residents into three grades: first-class college students' hospitalization reimbursement, second-class children's and adult residents' hospitalization reimbursement, and third-class adult residents' hospitalization reimbursement. China travel. Com will introduce in detail the proportion of hospitalization reimbursement for medical insurance for urban residents in Jinan.

Jinan social security card reimbursement scope, Jinan hospital reimbursement ratio Social security card has a wide range of functions. Cardholders can not only use the card for real-time settlement of medical insurance personal accounts, but also handle endowment insurance affairs; Go through the formalities of job registration and unemployment registration; Apply for unemployment insurance; Apply for employment training; Apply for labor ability appraisal and enjoy the work.

Proportion of medical insurance hospitalization reimbursement for urban residents in Jinan:

First, the proportion of college students' hospitalization reimbursement

1. For medical treatment in tertiary medical institutions, 60% shall be paid by residents' basic medical insurance fund and 40% shall be borne by individuals;

2 in the secondary medical institutions, residents' basic medical insurance fund to pay 70%, personal burden of 30%;

3 in a medical institution, township hospitals for medical treatment, by the residents' basic medical insurance fund to pay 80%, personal burden of 20%.

Second, the proportion of hospitalization reimbursement for children and adult residents

1. For medical treatment in provincial (ministerial) tertiary medical institutions, 40% of the residents' basic medical insurance fund will be paid, and 60% will be borne by individuals;

2 other tertiary medical institutions, paid by the residents' basic medical insurance fund 55%, personal burden 45%;

3 secondary medical institutions, paid by the residents' basic medical insurance fund 65%, personal burden 35%;

4 in the first-class medical institutions, 80% of the residents' basic medical insurance fund is paid, and the personal burden is 20%;

5. For medical treatment in township hospitals, 90% is paid by residents' basic medical insurance fund, and the personal burden is 10%.

Three. Proportion of hospitalization reimbursement for adult residents

1. For medical treatment in provincial (ministerial) tertiary medical institutions, 30% will be paid by the residents' basic medical insurance fund and 70% will be borne by individuals;

2 other three medical institutions, 45% paid by the residents' basic medical insurance fund, 55% personal burden;

3 secondary medical institutions, paid by the residents' basic medical insurance fund 60%, personal burden 40%;

4 in the first-class medical institutions, 80% of the residents' basic medical insurance fund is paid, and the personal burden is 20%;

5. For medical treatment in township hospitals, 90% is paid by residents' basic medical insurance fund, and the personal burden is 10%.

6. Improve the general outpatient co-ordination, and the reimbursement rate within the maximum payment limit is 50%.

Qifubiaozhun of medical insurance for urban residents in Jinan

College students hospitalization Qifubiaozhun for:

1. tertiary medical institutions in 700 yuan,

2. Secondary medical institutions in 400 yuan,

3 first-class medical institutions (including community health service institutions, the same below) and township hospitals in 200 yuan.

Qifubiaozhun for hospitalization of urban and rural residents is:

1. provincial (ministerial) level tertiary medical institutions 1200 yuan,

2. Tertiary medical institutions 1000 yuan,

3. Secondary medical institutions in 700 yuan,

4. First-class medical institutions and township hospitals are located in 400 yuan.

Note: In a medical year, the minimum threshold for the second hospitalization will be reduced by 20% accordingly, and the minimum threshold will no longer be implemented from the third hospitalization.

legal ground

Article 18 of the Regulations on Work-related Injury Insurance (revised 20 10) shall submit the following materials when applying for work-related injury identification:

(a) the application form for work-related injury identification;

(two) the existence of labor relations with the employer (including factual labor relations);

(3) Medical diagnosis certificate or occupational disease diagnosis certificate (or occupational disease diagnosis certificate).

The application form for ascertainment of a work-related injury shall include basic information such as the time, place and cause of the accident and the degree of injury of the employees.

If the materials provided by the applicant for work-related injury identification are incomplete, the social insurance administrative department shall inform the applicant in writing of all the materials that need to be supplemented at one time. The administrative department of social insurance shall accept the corrected materials after the applicant has been informed in writing.