Proportion of medical insurance reimbursement for employees in Anhui Province

1. reimbursement ratio of medical insurance for urban workers in Anhui province

The proportion of medical insurance reimbursement in Anhui Province is 90%.

2. Anhui social security medical reimbursement ratio

1. In a settlement year, medical expenses less than RMB 6,543,800+0,800, which meet the scope of reimbursement, occurred. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

2. At least 70 years old and above.

In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

3. Other urban residents

In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold for tertiary hospitals is 659 yuan, the reimbursement rate is 50%, and the upper limit is 2,000 yuan. The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.

3. The proportion of urban and rural medical insurance reimbursement in Anhui Province

1. Hospitalization in hospitals and medical institutions below, with reimbursement rate of 85%. The deductible line is 200 yuan.

2. Hospitalization in a secondary hospital, the reimbursement rate is 80%, and the deductible line is 500 yuan.

3. Hospitalization in a municipal tertiary hospital, the reimbursement rate is 70%, and the deductible line is 700 yuan; For hospitalization in a provincial tertiary hospital, the reimbursement rate is 75%, and the deductible line is 1000 yuan.

The deductible line of hospitalization in hospitals outside the city increased by 1 times, and the reimbursement rate decreased by 5%; For hospitalization in a provincial hospital, the deductible is calculated as 20% of the hospitalization expenses in the current period, but the maximum is not more than 1 10,000 yuan, and if it is less than 2,000 yuan, it is calculated as 2,000 yuan, and the reimbursement ratio is unified as 60%.

4. The proportion of medical insurance for employees and urban residents in Anhui Province has increased.

The establishment of diplomatic relations between Anhui and 66 yuan is "Anhui Bao Hui".

As an inclusive supplementary medical insurance, Wanhuibao only needs 66 yuan (60 yuan for family version) for one year, regardless of age, occupation and health status. As long as the basic medical insurance participants in Chuzhou city and counties and cities (including employees in Chuzhou city, counties and cities, urban and rural residents) can participate in the insurance, there is no waiting period. During the insured period, the hospitalization expenses due to accidents or diseases are not included in the medical insurance catalogue. After reimbursement of basic medical insurance and serious illness insurance, medical expenses such as operation expenses, medicine expenses, nursing expenses, examination expenses, bed expenses and treatment expenses that should be borne by individuals can be reimbursed. Among them, the guaranteed amount in the medical insurance catalogue is 6.5438+0.5 million yuan, and the guaranteed amount outside the catalogue is 6.5438+0.5 million yuan. After deducting the deductible of 20,000 yuan, it will be paid in the proportion of 75%.

5. What is the proportion of medical insurance reimbursement for urban workers in Anhui Province?

First, outpatient reimbursement: urban residents in the community health service center within the scope of the policy of outpatient expenses, according to the proportion of 50% reimbursement The maximum reimbursement for one time in 40 yuan is within one year 160 yuan. The maximum reimbursement limit for men over 60 years old and women over 55 years old is 240 yuan. Second, medical insurance supplementary report: Please take the initiative to show your medical insurance card or ID card when seeking medical treatment according to the regulations (/kloc-insured persons under 0/8 years old hold household registration books), and there is no supplementary report on outpatient expenses. Third, residents' medical insurance: after participating in residents' medical insurance, medical insurance cards will no longer be issued. When seeking medical treatment in designated medical institutions, residents can enjoy basic medical insurance benefits with their ID cards (/kloc-insured persons under 0/8 years old hold household registration books). Residents' medical insurance has been paid for four consecutive years, and it cannot be replaced by one-year employee medical insurance.

6. The proportion of urban and rural medical insurance reimbursement in Anhui Province

Hello,

Reimbursement for urban residents, students and children:

In a settlement year, medical expenses less than 6,543,800 yuan+0.8 million yuan that meet the scope of reimbursement occurred. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

7. Adjustment of reimbursement ratio of medical insurance for urban workers in Anhui Province

Outpatient reimbursement standard The proportion of reimbursement for general outpatient expenses in county, city and district hospitals is 55%. The outpatient medical expenses for chronic diseases can be reimbursed by 60%.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.

8 Anhui urban and rural medical insurance reimbursement ratio

The reimbursement rate for medical treatment in different places in Anhui Province is: 90% for employees' medical insurance (on-the-job), 60% for residents' medical insurance and 75% for the new rural cooperative medical system.

Conditions for reimbursement of medical insurance in different places, such as cash advance of medical expenses incurred by insured persons in handling registration procedures in different places, such as resettlement, visiting relatives, working and studying abroad, etc. The medical expenses incurred by the provincial insured who agreed to be transferred to designated medical institutions in Beijing and Shanghai after filing shall be paid in cash.

9. Proportion of reimbursement for basic medical insurance for urban and rural residents in Anhui Province

1, protecting population

Medical insurance for employees covers all employees of employers in cities and towns, urban residents of working age (such as on-the-job employees engaged in individual economy) and retirees enjoying pensions;

The coverage of residents' medical insurance refers to people who have urban household registration but have no jobs, such as the elderly who do not enjoy pensions, the unemployed of working age, teenagers, the disabled and other low-income objects and other urban non-employees

2. Payment standard

Medical insurance for urban workers pays monthly, and the payment standard is high;

Residents' medical insurance is paid annually, and the financing level is lower than that of employees' medical insurance.

3. Source of payment

Medical insurance for employees shall be jointly paid by employers and individuals. In addition, employee medical insurance does not enjoy government subsidies;

Residents' medical insurance is paid by individuals and will enjoy certain government subsidies.

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2. What is the reimbursement ratio of employee medical insurance and resident medical insurance?

The proportion of medical insurance reimbursement for employees is generally 70%-85%;

The proportion of medical insurance reimbursement for residents is generally 50%-70%.

3. Which is better, employee medical insurance or resident medical insurance?

Both employee medical insurance and resident medical insurance are national medical insurance policies, and there is no difference between good and bad, but the protection groups of the two policies are different.

If you are an employee, you must participate in employee medical insurance. Those who are suitable to participate in residents' medical insurance can participate in residents' medical insurance.

The state is also increasing financial support for residents' medical insurance, and constantly improving the treatment, which will eventually be the same as employee medical insurance.

The above data are compiled according to the information published online, and the specific policies are subject to the implementation of the final document. You can also call the local social security bureau at 12333 for free consultation.

10. medical insurance policy for urban workers in Anhui province

From 65438 to 0988, the government of China began to reform the free medical care system of government institutions and the labor insurance medical care system of state-owned enterprises. From 65438 to 0998, the China Municipal Government promulgated the Decision on Establishing the Basic Medical Insurance System for Urban Employees, and began to establish the basic medical insurance system for urban employees throughout the country.

The basic medical insurance system implements the principle of combining social pooling with personal account, organically combines social insurance with savings insurance, and realizes the organic combination of "horizontal" social and economic security and "vertical" personal self-protection, which is not only conducive to giving play to the advantages of social pooling and personal account, but also conducive to giving play to the advantages of personal account in stimulating and restraining.

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1. Accidental medical treatment: 70% of the insured's medical expenses incurred below 6,000 yuan. The reimbursement rate of hospitalization medical expenses above 6000 yuan is 80%, and the maximum payment limit is 350000 yuan.

2. Accidental disability: If physical disability is caused by accident, a one-time subsidy will be given according to the specific situation. The specific criteria are: if the disability level is identified as level 4, the subsidy will be 20,000 yuan; If the disability level is Grade III, the subsidy is 25,000 yuan; Disability level of 2, a subsidy of 30 thousand yuan; If the disability level is 1, the subsidy is 35,000 yuan.

3. Accidental death: In case of accidental death, a one-time subsidy of 50,000 yuan will be given.