How to reimburse Wuhan social security for medical treatment?

Specifically, if you want to know how to reimburse the social security card for medical treatment, you must refer to the specific reimbursement ratio.

First, the use of special medical materials or disposable medical materials with a unit price of more than/kloc-0,000 yuan, as well as the installation and replacement of artificial organs, shall be paid by the basic medical insurance pooling fund at 90% of the domestic general price;

Second, the basic medical expenses for outpatient dialysis of chronic renal failure, outpatient anti-rejection drugs after organ transplantation, outpatient chemotherapy, radiotherapy, interventional therapy or radionuclide therapy are paid by the basic medical insurance pooling fund;

Third, the outpatient special examination and treatment costs are paid by the basic medical insurance fund 80%, and the individual pays 20%;

Fourth, continuous payment is linked to the reimbursement ratio. After two years of continuous insurance, the reimbursement rate increased to 765,438+0%, and after four years of continuous insurance, the reimbursement rate increased to 72%, and so on.

It should be reminded that the reimbursement ratio of social security cards in different cities is different, which is mainly related to the local medical insurance benefits. It is suggested that you can call the social security number 12333 for consultation, or consult the local social security bureau!

Matters needing attention for hospitalization reimbursement of social security card:

1. Different hospitals have different reimbursement rates for medical insurance.

A person spends 10000 yuan in a hospital. If he is hospitalized in a first-class hospital, 500 yuan will be deducted first; If you are hospitalized in a secondary hospital, first subtract 1000 yuan; If you are hospitalized in a tertiary hospital, you will be reduced by 2000 yuan first; After excluding "non-medical insurance drug expenses" and "other non-medical insurance expenses", the remaining employees reported 80%, retired or unemployed, and unemployed 50%.

Note: Medical insurance reimbursement only covers Class A drugs, that is, medical insurance drugs, and Class B drugs are not medical insurance and cannot be reimbursed.

2. On-the-job employee hospitalization reimbursement ratio

For medical insurance hospitalization, except for the self-paid part and self-paid 10%, the part exceeding the hospitalization medical insurance deductible line enjoys the proportion of overall payment. Different levels of hospitals have different threshold fees and enjoy different proportions of overall payment. The proportion of medical insurance for employees is over 80% (82%/84%/87% in Wuhan), and that for residents is about 70% (80%/65%/50% in Wuhan).

From this perspective, the proportion of self-funded medical insurance hospitalization is hard to say. All self-funded parts are self-funded, and all threshold fees are self-funded. The second-class expenses shall be paid by 65,438+00% first, and then by 20% together with the first-class expenses.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.