2022 Beijing one old one small medical insurance reimbursement ratio

Beijing one old one small medical insurance reimbursement ratio above 1300 reimbursement 60%, a maximum of 150,000 yuan a year reimbursement, the second hospitalization reimbursement above 650 reimbursement 60%. You need to go to your community medical service center to get a referral certificate, except for emergencies, if you don't get a referral from a community medical institution, you will not be reimbursed manually. You need to go to the three general hospitals of your choice, and you can go directly to the Class A hospitals, Chinese medicine hospitals, and specialty hospitals without having to choose.

I. Refund procedures

Participants have paid the following year's health insurance premiums, in the year of payment by December 31, meet one of the following conditions, can be relevant proof of participation in the social security of the place where I apply for a refund of formalities:

(a) the death of the participant, the family members of the participant to provide medical institutions or public security departments, civil affairs departments issued by the certificate of death or related materials;

(b) the death of the participant, the family members of the participant to provide medical institutions or public security departments, civil affairs departments issued by the death certificate

(ii) residents of working age who are employed and participate in the basic medical insurance for urban workers, provide a copy of the labor contract issued by the unit;

(iii) if other conditions for refund are met, submit the appropriate materials.

Two, prepare the materials

No social security card medical handbook of the insured when hospitalized. Need to have a social security card in the hospital after a visit to activate the card before giving manual reimbursement, reimbursement need to produce social security card, diagnostic certificates, receipts, full copy of the medical record, the situation description, (name, identity card number, which day of the day admitted to the hospital and which day of the day of the hospital, the doctor diagnosed what disease, at that time, due to what reason did not real-time billing in the hospital, I implore the social security center to give the manual reimbursement. (Applicant, time) my Postal Savings Bank passbook or Bank of Beijing Beijing card (debit card). When seeking medical treatment, you need to go to your community medical service center to issue a referral certificate, except for emergencies, if you do not go through the community medical institution referral, otherwise no manual reimbursement will be given.

Three, an old and a small insurance coverage:

Students and children's insurance coverage: all non-agricultural household registration in Beijing, and in the designated area of Beijing, all kinds of general institutions of higher learning (full-time academic education), general primary and secondary schools, secondary vocational schools (including secondary vocational schools, technical schools, vocational high schools), special education schools, work-study schools registered students Students and children who are not enrolled in schools, including children in childcare institutions, diaspora infants and toddlers, and other children under 16 years of age who are not enrolled in schools, are eligible to participate in the Medical Insurance for Major Diseases for Students and Children. Currently, the coverage has been expanded to include full-time college students and full-time graduate students of Beijing origin who are attending schools outside of Beijing.

Legal basis:

The Social Insurance Law of the People's Republic of China

Article 23 Employees shall participate in the basic medical insurance for employees, and shall pay the basic medical insurance premiums by the employing unit and the employees in accordance with the provisions of the State***.

Individual industrial and commercial households without employees, part-time employees who do not participate in the basic medical insurance for employees at their employing units, and other flexibly employed persons may participate in the basic medical insurance for employees, and shall pay the basic medical insurance premiums in accordance with the State regulations.

Article 28: Medical expenses in accordance with the basic medical insurance drug list, diagnostic and therapeutic items, standards of medical service facilities, as well as emergency and rescue medical expenses shall be paid out of the basic medical insurance fund in accordance with the state regulations.