Beijing medical insurance 1800 reimbursement rules

Beijing Health Insurance 1800 Reimbursement Rule means that in Beijing's health insurance system, outpatient medical expenses incurred by a participant within a year can be reimbursed at a certain percentage after reaching the starting threshold of 1800 yuan.

Specifically, when a participant's outpatient medical expenses reach a total of 1,800 yuan within a year, he or she can begin to enjoy reimbursement for the portion that exceeds that amount. The reimbursement rate varies according to different medical programs and hospital grades, and generally ranges from 50% to 95%. This means that the insured can get a certain percentage of reimbursement according to the actual situation when paying for medical expenses, which reduces the financial burden. It is important to note that the Beijing Health Insurance 1800 reimbursement rule only applies to outpatient medical expenses and does not include inpatient medical expenses. In addition, different reimbursement rules and percentages may apply to different types of health insurance and participant status. Therefore, when enjoying the reimbursement of medical insurance, participants need to carefully understand the relevant rules and requirements to avoid unnecessary misunderstanding and trouble.

Advantages of Beijing medical insurance reimbursement:

1. Reducing the burden of medical expenses. After the reimbursement of outpatient medical expenses within the year, the second reimbursement will be made by the medical insurance fund according to a certain percentage for the portion of individual out-of-pocket payment exceeding 1,800 yuan in total.

2. Improving the level of medical protection. Beijing medical insurance further improves the level of medical protection while protecting the basic medical needs of the insured.

3. Optimizing the allocation of medical service resources. It helps guide participants to choose medical services reasonably and optimize the allocation of medical resources.

4. Promote the healthy development of the medical insurance system. By continuously improving medical insurance policies and raising the level of medical insurance protection, it helps to enhance the sense of achievement and satisfaction of the insured and improve the credibility and influence of the medical insurance system.

In summary, the Beijing health insurance 1800 reimbursement rules are a system set up to protect the basic medical needs of the insured. By setting the starting line and reimbursement rate and other measures, it can effectively control the expenditure of medical insurance, promote the rational use of medical resources, and enable the insured to get better medical insurance services.

Legal basis:

Social Insurance Law

Article 28

Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and treatment items, standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.

Article 29

The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.

The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.