Proportion of reimbursement for long-term outpatient service

In order to deepen the reform of medical and health system, expand the coverage of outpatient basic medical insurance, ensure the basic medical needs of insured persons and ensure the rational use of basic medical insurance funds, the outpatient basic medical insurance system is slowly being rolled out to the society. The problem of difficult and expensive medical treatment has been alleviated. Outpatient medical insurance reimbursement ratio, employee medical insurance wants to know more about the specific proportion of outpatient medical insurance reimbursement, let's take a look.

Proportion of reimbursement for outpatient medical insurance

First, the employee medical insurance outpatient reimbursement ratio:

After the on-the-job employees see a doctor in the outpatient and emergency department of the hospital, the medical expenses of more than 2,000 yuan can be reimbursed, and the reimbursement ratio is 50%. For retirees under 70 years old, expenses above 1300 yuan can be reimbursed, and the reimbursement rate is 70%. For retirees over 70 years old,180% of the expenses above 300 yuan can be reimbursed. No matter what kind of people, the maximum payment limit for outpatient and emergency medical expenses is 20 thousand yuan. For example, if you are an on-the-job employee, and the outpatient medical expenses are 2,500 yuan, then this 500 yuan can be reimbursed 50%, that is, 250 yuan.

Two, residents' medical insurance outpatient reimbursement ratio:

Outpatient settlement procedure: Insured patients will pay the medical expenses incurred in the outpatient service of designated medical institutions directly by swiping the card at the resident medical insurance settlement counter with the special medical insurance prescription and social security card. In an insurance year, if the total outpatient expenses are below 50 yuan, the medical insurance fund will pay 40%, and the expenses above 50 yuan will be borne by individuals.

Three, rural medical insurance outpatient reimbursement ratio:

60% of the medical expenses of village clinics and village center clinics are reimbursed, and the prescription drug fee limit for each visit is 10 yuan, and the prescription drug fee limit for temporary rehydration of hospital doctors is 50 yuan.

40% reimbursement for medical treatment in the town health center, with the limit of examination fee and operation fee for each visit, and the limit of prescription drug fee 100 yuan.

The reimbursement for medical treatment in secondary hospitals is 30%, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan.

Third-level hospitals will be reimbursed 20%, with the examination fee and operation fee for each visit limited to 50 yuan and prescription drug fee limited to 200 yuan.

Chinese medicine invoice with prescription, limit 1 yuan.

The annual compensation limit for rural cooperative medical clinics is 5000 yuan.