Employee medical insurance reimbursement policy for chronic diseases

The reimbursement policies for employees' chronic disease medical insurance are as follows:

1, Qifubiaozhun for chronic diseases, 300 yuan;

2, chronic disease reimbursement ratio, according to the low standard payment of adult residents reimbursement ratio of 50%; The reimbursement rate for minor residents and adult residents who pay according to the high-grade standard is 60%;

3, malignant tumor radiotherapy and chemotherapy, uremia dialysis treatment, tissue and organ transplantation after taking anti-rejection drugs outpatient treatment expenses reimbursement has no deductible, according to the low standard of adult residents reimbursement ratio is 70%, minor residents according to the high standard of adult residents reimbursement ratio is 80%;

4. The annual expense reimbursement standard for taking anti-rejection drugs after uremia dialysis treatment and organ transplantation is paid according to the low standard, and the payment limit for adult residents is 60,000 yuan. The limit for underage residents and adult residents who pay according to high-grade standards is 80,000 yuan.

The materials required for slow maintenance applications are as follows:

1. First, write an application in the name of the insured person and write it to the social security management office in the area where the account belongs;

2. Outpatient medical records for treating this disease;

3, must be hospitalized for this disease within two years, including discharge summary, original and copy;

4, a copy of the relevant information in the discharge medical records, must be stamped with the red chapter of the hospital;

5. Fill in the application form for serious illness at the social security office where the account is located;

6, together with the above information, send it to the medical insurance department of the regional social security management office for review;

7. After the regional social security is approved, give a form and then identify it in the designated hospital;

8. After the appraisal hospital is stamped, go to the regional social security review, hand in one-inch registration photos, and inform the designated hospital for treatment.

To sum up, patients with chronic diseases who participate in medical insurance can enjoy medical insurance outpatient chronic disease subsidy as long as they meet the standard of chronic disease subsidy.

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. Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.