Proportion of medical expenses reimbursed by social security in Tianjin

What is the reimbursement ratio of social security and medical insurance in Tianjin? Everyone should know the importance of medical insurance to us, but when it comes to his reimbursement rate, everyone is not very thorough, so I have compiled the following contents, hoping to help you. Tianjin social security medical insurance reimbursement ratio: different hospitals have different medical insurance reimbursement ratios. If anyone wants to know more about the reimbursement rate of social security and medical insurance in Tianjin, let's take a look with me.

First, Tianjin social security medical insurance reimbursement ratio:

1. Different hospitals have different reimbursement rates for medical insurance.

A person spends 10000 yuan in a hospital. If he is hospitalized in a first-class hospital, 500 yuan will be deducted first; If you are hospitalized in a secondary hospital, first subtract 1000 yuan; If you are hospitalized in a tertiary hospital, you will be reduced by 2000 yuan first; After excluding "non-medical insurance drug expenses" and "other non-medical insurance expenses", the remaining employees reported 80%, retired or unemployed, and unemployed 50%. Note: Medical insurance reimbursement only covers Class A drugs, that is, medical insurance drugs, and Class B drugs are not medical insurance and cannot be reimbursed.

2. On-the-job employee hospitalization reimbursement ratio

For medical insurance hospitalization, except for the self-paid part and self-paid 10%, the part exceeding the hospitalization medical insurance deductible line enjoys the proportion of overall payment. Different levels of hospitals have different threshold fees and enjoy different proportions of overall payment. The proportion of medical insurance for employees is over 80% (82%/84%/87% in Wuhan), and that for residents is about 70% (80%/65%/50% in Wuhan). From this perspective, the proportion of self-funded medical insurance hospitalization is hard to say. All self-funded parts are self-funded, and all threshold fees are self-funded. The second-class expenses shall be paid by 65,438+00% first, and then by 20% together with the first-class expenses. Very complicated! In fact, the computer system will automatically calculate. Medical insurance hospitalization, show the medical insurance card, read the card into the medical insurance system, pay the deposit (usually the threshold fee), and enter the fee into the system. The system automatically classifies it as self-funded, Class A, Class B, etc. Class B pays 65,438+00% first, and then enters the basic medical care. According to the annual number of inpatients (more than 1 threshold fee halved), hospital level (different threshold fees,

The calculation formula is as follows: the total medical expenses is 9000 yuan, and the reimbursement formula is [9000-500 (self-paid)-self-paid drugs ]*80%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed. Generally speaking, the economic development in different regions is different, so the reimbursement ratio is different. The following is an explanation of the proportion of employees' medical insurance in Beijing.

Second, how to inquire about medical insurance

1, social security center query

If you don't know your social security account number, you can bring your ID card to the business hall of social insurance agencies in various districts to inquire.

2. Online inspection

Log in to the city's labor security network or social insurance business website, click the "Personal Social Security Information Inquiry" window, and enter my ID card and password (the password is your social security number or the date of birth of your ID card) to inquire about my insurance information.

3. Telephone consultation

Call the labor and social security comprehensive service telephone number "12333" for policy consultation and information inquiry.

I'm here to sort out the information about these problems, hoping to help you. The laws in China are gradually improving, and we look forward to helping more people.