Nanjing medical insurance hospitalization reimbursement ratio 2023?

In 2023, the reimbursement rate of medical insurance in Nanjing will be 60%, and the reimbursement rate of outpatient service will be 50%. Different categories of medical insurance participants, medical institutions and medical catalogues have different reimbursement standards.

According to the "Adjustment Plan for the Payment Ratio of Hospitalization and Outpatient Expenses in Nanjing Medical Insurance (202 1-2023)" issued by the General Office of Nanjing Municipal People's Government, the reimbursement ratio of hospitalization expenses and outpatient expenses in Nanjing medical insurance will increase to 60% and 50% in 2023. Specifically, the reimbursement ratio of medical insurance participants depends on their different categories and grades. Specifically, medical insurance for urban workers, basic medical insurance for urban residents, new rural cooperative medical insurance, serious illness insurance for urban and rural residents, and supplementary medical insurance for enterprises have different requirements for the proportion of hospitalization reimbursement. At the same time, different medical institutions and medical catalogues also have different reimbursement standards. For example, only 50% of the drugs in the restricted drug list of basic medical insurance can be reimbursed, and the outpatient and hospitalization expenses in the unrestricted drug list can be reimbursed at a higher rate. It should be noted that this is only the specific situation in Nanjing. The proportion of medical insurance reimbursement in other cities may be slightly different, and the specific situation needs to be determined according to local policies.

Besides medical insurance, what other ways can reduce medical expenses? In China, besides medical insurance, there are many ways to reduce medical expenses. For example, by purchasing commercial medical insurance to increase the protection of medical expenses; Online shopping for prescription drugs can enjoy certain discounts; Regular physical examination and vaccination can reduce the probability of illness, thus reducing medical expenses.

Medical expenses have always been one of the topics that people are most concerned about. With the adjustment and reform of national policies, the proportion of medical insurance reimbursement is also increasing. In addition, individuals can also reduce their medical expenses in various ways.

Legal basis:

The hospitalization expenses for major diseases stipulated in Article 29 of the Regulations on the Basic Medical Insurance for Urban Employees in People's Republic of China (PRC) shall be paid in the following ways:

(a) Qifubiaozhun in principle control in the city, county, autonomous county last year, 9% of the average social wage of workers to 1 1.

(two) the maximum payment limit is controlled in principle at 3 to 5 times the average social wage of employees in cities, counties and autonomous counties in the previous year.

(three) medical expenses above the minimum deductible and below the maximum payment limit are mainly paid by the overall fund, and individuals bear a certain proportion. Give appropriate care to the proportion of retirees who bear medical expenses.

The scope of serious diseases, the specific standards of Qifubiaozhun and the maximum payment limit, and the proportion of sharing medical expenses above Qifubiaozhun and below the maximum payment limit shall be determined by the provincial people's government.