How to reimburse the first medical insurance clinic in Shenzhen?

Legal analysis: general outpatient service: 1, outpatient service of directional medical institutions in the city: the medical insurance catalogue fee is deducted from the personal account, and the unpaid part of the personal account is paid by the insured. 2. See a doctor at a designated community health center in the city: 70% of the expenses in the medical insurance catalogue are paid by the personal account, and 30% are paid by the basic medical insurance serious illness pooling fund and the local supplementary medical insurance fund according to the regulations (except for the following items: dental treatment expenses; Rehabilitation physiotherapy expenses; Large-scale medical social security examination and treatment expenses; Other project expenses stipulated by the municipal government) outpatient serious illness: insufficient continuous insurance time 12 months: 60%. Continuous insurance time 12-35 months: 75%. Continuous insurance for 36 months or more: 90%. Outpatient blood transfusion: 90%. Outpatient special examination: 80%. Outpatient annual overrun: the outpatient medical expenses paid by individuals who have been insured for one year in a row and within the unified medical insurance year exceed the average salary of employees in this city by 5% in the previous year (at present, it is 6387.85), and the medical insurance fund will reimburse 70% for the excess; Insured over 70 years old: 80%.

Legal basis: Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid from the basic medical insurance fund in accordance with state regulations.