Total reimbursement rate for children

The proportion of reimbursement for children's medical insurance varies according to different treatment methods. According to the level of hospitals, the reimbursement rate of children's medical insurance is 85% in first-class hospitals, 70% in third-class hospitals and 50% in outpatient treatment. First, the precautions of neonatal insurance, the insured object is limited to newborns with local household registration, and second, the time to enjoy insurance varies according to the time of insurance.

1. What is the specific proportion of children's medical insurance reimbursement?

The proportion of reimbursement for children's medical insurance is as follows:

1. hospitalization reimbursement ratio

The reimbursement rates of tertiary, secondary and primary hospitals are 70%, 80% and 85% respectively, and the minimum payment standard is 100 yuan in 300 yuan and 200 yuan respectively. Reminder: If the insured minor residents are transferred to other places for treatment, the proportion of medical insurance reimbursement is 70%, and the minimum payment standard is 1500 yuan.

2. Outpatient reimbursement

In the medical insurance settlement year, the general outpatient medical expenses incurred by the insured minor residents in designated community health service centers (stations), township hospitals or school hospitals (school outpatient departments and school clinics) and other grassroots designated medical institutions shall be borne by the individual first, and the medical expenses that meet the Qifubiaozhun above the basic medical insurance payment scope shall be paid by the overall planning fund for 50%, and the annual overall planning fund shall pay the highest 300 yuan.

Second, the newborn insurance matters needing attention

Newborns should pay attention to the following items:

1. Only newborns with local household registration.

2. If you apply for insurance within the household registration 1 month and can provide a copy of your birth certificate and your mother's ID card, you can pay the fee from the month of birth and enjoy medical insurance benefits from the date of birth.

3. If the applicant has gone through the insurance formalities within 1 month after entering the household, and fails to provide a copy of the birth certificate and the mother's ID card, he will pay the fee from the month of application and enjoy medical insurance benefits from the month after payment.

4. If you go through the insurance formalities after the household registration 1 month, you will pay the fee from the month of application and enjoy the medical insurance benefits from the month after payment.

Third, how to activate the children's medical insurance card

The activation method of children's medical insurance card is as follows:

1. The insured person needs to bring his social security card and the original identity certificate to the corresponding bank outlet to activate the social security card, and the medical insurance account will return to normal after activation.

2. Use the social security card to directly enable the social security function in the designated medical insurance hospital. When the insured person uses the social security card for the first time in a designated medical institution, he can directly activate the social security function by simply registering for outpatient service or hospitalization.

3. When the insured uses the social security card for the first time in the designated medical insurance pharmacy, he inserts the original medical insurance card and then inserts the social security card as required to activate the social security card.