How to calculate Dalian medical insurance reimbursement

1. What is the reimbursement rate for medical insurance?

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. Very complicated! In fact, the computer system will automatically calculate. Medical insurance hospitalization, show the medical insurance card, read the card into the medical insurance system, pay the deposit (usually the threshold fee), and enter the fee into the system. The system automatically classifies it as self-funded, Class A, Class B, etc. Class B pays 65,438+00% first, and then enters the basic medical care. According to the annual number of inpatients (more than 1 threshold fee halved), hospital level (different threshold fees,

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