What is the proportion of tertiary reimbursement for medical insurance in Shenzhen?

Legal analysis: general outpatient service:

Paid by the community outpatient co-ordination fund.

Among them, 80% are Class A drugs; Class B drugs 60%

Single diagnosis or treatment or materials: 90% "less than or equal to 120 yuan"

The maximum annual payment of medical insurance is less than or equal to 1000 yuan.

Specific instructions:

Before going to the hospital, you need to bind the designated community health center in the city.

It will take effect after binding or changing the community health center and enjoy relevant treatment.

Outpatient serious illness

The continuous insurance period is less than 12 months (60%)

Continuous insurance time exceeds 12 months (75%)

The continuous insurance period is 36 months (90%)

Specific instructions:

After handling the identification procedures for serious and serious diseases in outpatient department, you can choose any designated medical institution in the city for medical treatment.

Outpatient transfusion: 70%

Specific instructions:

You can choose any designated medical institution in the city for medical treatment.

Outpatients who are referred or rescued in non-settlement hospitals for work reasons.

The payment standard is 90% on the basis of the three-level general outpatient service and outpatient serious illness regulations in this city.

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

Article 1 This Law is formulated in accordance with the Constitution for the purpose of adjusting the social insurance relationship, safeguarding citizens' legitimate rights and interests in participating in social insurance and enjoying social insurance benefits, enabling citizens to enjoy the fruits of development and promoting social harmony and stability.

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.