Children's outpatient social security reimbursement Qingdao

1, the annual outpatient maximum reimbursement of 300 yuan

Qingdao children and teenagers after the insurance procedures, you can take the social security card near the choice of a community hospital contract, which is Qingdao from 2015 onwards for children and teenagers of a new policy.

After signing a contract with a community hospital, a child who has a headache or a fever can go to the community hospital to see a doctor and get medicine, and the cost will be reimbursed instantly, with a reimbursement rate of 40 percent and a maximum annual reimbursement of 300 yuan.

The Municipal Social Security Bureau requires that designated communities should arrange for family doctors to see children and adolescents. Communities that are in a position to do so should arrange for physicians whose scope of practice is pediatrics to see children and adolescents. The designated communities should actively bring in doctors specializing in pediatrics to practice in the designated communities.

2. 80% reimbursement for hospitalization in a tertiary designated hospital

According to Qingdao's current policy, if children and adolescents need to be hospitalized for treatment of illnesses, the starting standard for hospitalization medical fees shall be set up in accordance with the standard of 800 yuan for tertiary medical institutions, 500 yuan for secondary medical institutions, and 200 yuan for tertiary medical institutions. In a medical year, the first hospitalization, the starting standard in accordance with the implementation of 100%; the second hospitalization, the starting standard in accordance with the implementation of 50%; the third and above hospitalization, the starting standard in accordance with the implementation of 100 yuan.

Medical expenses incurred by children and adolescents who are hospitalized in first-, second-, and third-level designated medical institutions that are covered by the coordinated payment system above the starting standard are paid at 90%, 85%, and 80% of the coordinated payment rate, respectively. For the hospitalized medical expenses of an only child, the basic medical insurance fund increases by 5 percentage points on top of the prescribed payment ratio for student children.

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