How to reimburse hospitalization medical expenses in Zhongshan?

(1) Reimbursement scope: hospitalization expenses incurred by insured persons in designated hospitals or specialized hospitals, Chinese medicine hospitals and 3A hospitals selected by individuals;

(2) Reimbursement ratio: The minimum threshold for the first hospitalization in a natural year is 1.300 yuan, and 650 yuan every time thereafter. The payment ratio is divided into three grades. Take a tertiary hospital as an example. The floating standards are: 30,000 yuan, 85% on the job, 9 1% for retirement, 90% for 30,000-40,000, 94% for retirement, more than 40,000, 95% for employment and 97% for retirement. 90 days of general hospitalization is a settlement cycle. Psychiatric hospitalization for 360 days is a settlement cycle, and the floating standard is halved. In a natural year, the overall fund pays a maximum of 70,000 yuan. The maximum hospitalization amount is 654.38+10,000 yuan, and the hospitalization ratio is 70%;

(3) Medical treatment management: If the unit pays the full fee, the individual can go through the hospitalization formalities only by paying part of the hospitalization advance payment. The medical expenses incurred should conform to the scope of the three major catalogues of medical insurance;

(IV) Reimbursement process: When leaving the hospital, the hospital and the individual will settle the self-funded and self-funded amount, and the reimbursement amount of the overall fund will be settled by the hospital and the district medical insurance center.