The proportion, policies, conditions and scope of medical insurance reimbursement from 2002 to 2022 in Zhongshan.

The latest regulations of Zhongshan medical insurance: the scope and proportion of reimbursement

The latest coverage of basic medical insurance is:

⊙ Insufficient payment for continuous insurance 1 year.

⊙ Continuous insurance payment is over 1 year (inclusive).

Continuous participation in supplementary medical insurance payment

More than 1 year but less than 2 years

More than 2 years but less than 3 years

More than three years.

The reimbursement ratio of Zhongshan medical insurance The deductible line and reimbursement ratio of urban residents' basic medical insurance are determined according to the categories of insured persons.

1, students and children. In a settlement year, medical expenses below RMB 6,543,800+0,800 yuan that meet the scope of reimbursement occurred. The threshold for tertiary hospitals is 500 yuan, and the reimbursement ratio is 55%; 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%.

They are old people in their seventies. In a settlement year, medical expenses below RMB 6,543,800+that meet the scope of reimbursement occur, and the threshold for tertiary hospitals is 500 yuan, and the reimbursement ratio is 50%; 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 RMB 6,543,800+that meet the scope of reimbursement occur, and the threshold for tertiary hospitals is 500 yuan, and the reimbursement ratio is 50%; 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%.

Urban residents hospitalized for more than two times in a settlement year, starting from the second hospitalization, no longer charge Qifubiaozhun fees. Transfer or hospitalization for more than two times, make up the difference of Qifubiaozhun in accordance with the provisions of transfer or hospitalization again.