Proportion of reimbursement for outpatient medical insurance in Guangzhou

Guangzhou medical insurance reimbursement amount is determined by the proportion of medical insurance reimbursement and the minimum payment standard. Details are as follows:

1, the reimbursement rate of medical insurance for employees in this city is 75% for general outpatient service;

2, chronic disease reimbursement 85%; The qifubiaozhun for tertiary medical institutions is 1600 yuan;

3. 800 yuan, a secondary medical institution, and 400 yuan, a primary medical institution.

The information required to apply for a medical insurance card is as follows:

1, ID card: valid identification, such as ID card and passport, is required. ;

2. Residence booklet or residence permit: some areas may need to provide residence booklet or residence certificate to prove residence and identity information;

3. Social security certificate: if it is the first time to participate in medical insurance, you need to provide a social security certificate issued by the social security bureau of the original insured place to prove that you have participated in social security and paid social insurance premiums;

4. Certificate of the unit: if it is an employee of the unit, you need to provide the certification materials issued by the unit, such as work permit and labor contract;

5. Photo: Need a recent photo.

The reimbursement process after individuals pay medical insurance is generally as follows:

1. See a doctor: When you see a doctor or buy medicine in a medical institution, you need to show your medical insurance card, ID card and other relevant documents;

2. Preparation of reimbursement materials: after seeing a doctor, you need to go to a medical institution to obtain medical records, doctor's orders, prescriptions, receipts and other related materials, and fill in the relevant reimbursement application form;

3. Submit reimbursement application: submit the prepared reimbursement materials and application forms to the local social security bureau or medical insurance center for reimbursement application. You can also choose to apply for reimbursement online;

4. Review the reimbursement application: the local social security bureau or medical insurance center will review the submitted reimbursement application, and after the approval, the reimbursement will be credited to the personal bank account.

To sum up, the reimbursement ratio between different hospitals and designated medical insurance pharmacies may be different, and the specific situation needs to be determined according to local relevant regulations and policies.

Legal basis:

Article 2 of People's Republic of China (PRC) Social Insurance Law

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.

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.