Qingdao reimbursement policy for serious illness

According to the policy of Qingdao's serious illness insurance, after enjoying the medical expenses within the scope of basic medical insurance payment, the insured can apply for serious illness insurance to reimburse the remaining medical expenses if the medical expenses that need to be paid due to serious illness exceed the upper limit of personal account balance or the scope of medical insurance payment.

The specific reimbursement standards are as follows:

1. reimbursement scope of major illness insurance: major illness insurance covers 57 major diseases, including malignant tumor, pneumoconiosis, cirrhosis and cerebral hemorrhage.

2. Reimbursement ratio: the reimbursement ratio of major illness insurance is 80%.

3. Reimbursement ceiling: The reimbursement ceiling for serious illness insurance is 300,000 yuan, that is, a person can be reimbursed up to 300,000 yuan a year.

The related contents of reimbursement for serious illness are as follows:

1. Scope of application of reimbursement for serious illness: The specific scope of application varies according to regions and medical insurance policies, and generally refers to diseases that need to pay more than a certain amount of medical expenses. The reimbursement scope and standards of different regions and types of medical insurance are also different.

2. Reimbursement proportion of serious illness reimbursement: The reimbursement proportion of serious illness reimbursement is generally high, and the specific proportion varies according to different regions and medical insurance policies. Generally, different reimbursement rates and reimbursement limits are determined according to factors such as medical insurance types and individual contributions.

3. Critical illness reimbursement application process: Critical illness reimbursement application needs to be carried out in local social security and medical insurance institutions. Generally, it is necessary to provide medical expense invoices, hospitalization certificates, diagnosis certificates and other relevant supporting documents. After filling in the application form, the medical insurance institution will review the reimbursement according to the medical insurance policy.

4. Precautions for reimbursement of serious illness: People with medical insurance cards should understand medical insurance policies and regulations before seeking medical treatment, and try to choose designated hospitals for medical insurance to avoid reimbursement problems caused by different places of medical treatment. At the same time, in the process of medical treatment, medical expense invoices and related supporting documents should be properly kept to facilitate the subsequent reimbursement process.

To sum up, reimbursement for serious illness is an important part of medical insurance policy, which can provide some financial support and guarantee for some diseases that require high medical expenses. At the same time, we should also strengthen the publicity and popularization of medical insurance policies, improve people's understanding and participation in medical insurance policies, and safeguard the fairness and sustainability of medical insurance.

Legal basis:

Twelfth "People's Republic of China (PRC) the State Council on the establishment of the basic medical insurance system for urban workers".

The basic medical insurance premium is levied on a monthly basis, and the employer and employees shall pay the basic medical insurance premium to the tax collection authority within the prescribed time limit. The part that individual employees should pay shall be withheld and remitted by the employer from their wages.