Proportion of reimbursement for new rural cooperative medical system in Shijiazhuang Second Hospital

Legal analysis: the reimbursement ratio is determined by the nature of medical insurance, which is not different for different hospitals, but the threshold of different hospitals is different. If you seek medical treatment locally, you will be provided with a social security card when you are hospitalized, and the medical insurance will be settled (reimbursed) immediately when you leave the hospital. If you are hospitalized in a different place in Shijiazhuang, you should apply for a referral certificate in the local area and make a good referral record. Hospitalized in Shijiazhuang, medical insurance will be settled in different places immediately. Generally speaking, the general outpatient and emergency expenses incurred by the insured in designated medical insurance hospitals or specialist hospitals, traditional Chinese medicine hospitals and tertiary hospitals selected by individuals. In a natural year, the general outpatient emergency expenses accumulated more than 1800 yuan. The reimbursement rate is above 1800, 70% in hospitals and 90% in communities, with a ceiling of 20,000 yuan. Consult the local medical insurance department for details.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Article 2 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 in case of old age, illness, industrial injury, unemployment and maternity.

Article 4 Employers and individuals who pay social insurance premiums according to law in People's Republic of China (PRC) have the right to inquire about payment records and personal rights and interests records, and ask social insurance agencies to provide social insurance consultation and other related services.

Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.

Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium 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 treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.