Proportion of ct reimbursement to medical insurance reimbursement

The reimbursement rate of hospitalization medical insurance is generally 60%. Proportion of reimbursement for hospitalization medical insurance: reimbursement scope: medicine fee: auxiliary examination: 200 yuan for examination fees such as electrocardiogram, X-ray fluoroscopy, radiography, laboratory test, physiotherapy, acupuncture, CT and nuclear magnetic resonance; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan). The elderly over 60 years old are hospitalized in health centers, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan. Reimbursement ratio: town health centers reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%. The reimbursement rate of outpatient medical insurance: 60% in village clinics and village center clinics, the limit of prescription drugs per visit 10 yuan, and the limit of prescription drugs for temporary rehydration by doctors in health centers in 50 yuan; 40% reimbursement for medical treatment in the town health center, with the limit of 50 yuan for each medical examination and operation fee and the limit of prescription fee 100 yuan; Second-level hospitals will be reimbursed 30% for medical treatment, with each examination fee and operation fee limited to 50 yuan and prescription drug fee limited to 200 yuan; Third-level hospitals will be reimbursed 20% for medical treatment. The examination fee and operation fee for each visit are limited to 50 yuan, and the prescription drug fee is limited to 200 yuan; Chinese medicine invoice with prescription, each paste limit 1 yuan; The annual limit of outpatient compensation for township-level cooperative medical care is 5000 yuan.

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.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and 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 treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Derivative problem:

What is the proportion of medical insurance reimbursement for over-transfer personnel?

Reimbursement ratio: if the emergency expenses of general outpatient service exceed 2,000 yuan in a natural year, 50% will be paid by some large medical mutual aid funds above 2,000 yuan, and 50% will be paid by individuals themselves. The expenses not reimbursed by medical insurance are as follows: 1, service items: registration fees, out-of-hospital consultation fees, medical records fees, etc. Special medical services such as visiting fees, expedited fees for examination and treatment, additional fees for name-calling surgery, additional fees for name-calling surgery, high-quality and good-price fees, and self-invited special care. 2, diagnosis and treatment equipment and medical useful materials: the application of positron emission tomography (pet), electron beam ct, ophthalmic excimer laser therapeutic equipment and other large medical equipment for inspection and treatment projects. Glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation appliances. All kinds of self-use health care, massage, examination and treatment equipment. Disposable medical materials that are not charged separately as stipulated by the provincial price department. 3. Treatment items: organ sources or tissue sources of various organ or tissue transplants; Transplantation of organs or tissues other than kidneys, heart valves, corneas, skin, blood vessels, bones and bone marrow; Orthopedic surgery for myopia; Qigong therapy, music therapy, health nutrition therapy, magnetic therapy and other auxiliary treatment projects.