How does Hangzhou Social Security reimburse medical expenses?

Social security includes medical insurance, and the reimbursement method of medical insurance medical expenses is: (1) outpatient medical expenses reimbursement: outpatient family account is reimbursed according to the family limit, and the total amount is calculated according to each person 10 yuan and the number of indoor participants, and the whole family can adjust the use within the total reimbursement limit; Outpatient co-ordination is implemented according to the standard of 40 yuan/person/year, and the compensation ratio is 30% each time. Outpatient care should be people-oriented and family personnel adjustment should not be implemented. Out-of-county outpatient expenses will not be reimbursed temporarily. (2) Reimbursement of hospitalization medical expenses: reimbursement shall be managed with deductible line, reimbursement according to specified proportion and accumulative reimbursement capping. After the self-funded project is cleared, the medical expenses below the deductible standard shall be paid by the patient; For medical expenses exceeding the deductible line, the reimbursement rate is 75% in 50 yuan of the first-level hospital, 45% in 300 yuan of the second-level hospital, and 20% in the third-level hospital. Chinese medicine services will be increased by 10 percentage point on the basis of the compensation ratio of similar designated medical institutions. The maximum amount of accumulated reimbursement per person for the whole year is 30,000 yuan. (3) reimbursement of medical expenses for chronic disease clinics: According to your father's situation, you can be identified as a chronic disease patient. Within one year, the outpatient medical expenses of the month of hospitalization due to illness will be deducted, and the remaining expenses will exceed 150 yuan. On the basis of the chronic disease diagnosis certificate, outpatient invoice, prescription, hospital outpatient medical records, household registration book and diagnosis certificate that I applied for and designated the hospital. Submit it to township hospitals or central hospitals for review before June 30th of that year 165438+, and submit it to the county joint management office for approval before June 65438+February 10, and make compensation in the chronic disease medical fund. The deductible line is 150 yuan, and the compensation ratio is determined by the county joint management office according to the incidence of chronic diseases in the county.

Legal objectivity:

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

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.

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

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.