Proportion of reimbursement for medical treatment in different provinces of Heilongjiang Province

The reimbursement rate of medical insurance for off-site hospitalization in Heilongjiang Province is 60%. Specifically, registered residents in Heilongjiang province who are hospitalized in other provinces can apply for reimbursement of medical insurance in different places, and the reimbursement rate is 60%. However, it should be noted that the reimbursement ratio is determined according to the items in the medical insurance catalogue, and the reimbursement ratio of different items may be different. In addition, it should be reminded that medical insurance reimbursement for hospitalization in different places needs to meet certain conditions, such as handling reimbursement procedures within the specified time and hospitalization according to the medical insurance catalogue. If it does not meet the requirements, it may affect the reimbursement ratio, or it may not be reimbursed.

Proportion of outpatient medical reimbursement in different provinces of Heilongjiang Province:

1, reimbursement ratio of employee medical insurance outpatient service:

(1) Only after the on-the-job employees see a doctor in the emergency department of the hospital can the medical expenses of more than 2,000 yuan be reimbursed, and the reimbursement ratio is 50%;

(2) For retirees under the age of 70, the expenses above 1.300 yuan can be reimbursed, and the reimbursement rate is 70%;

(3) For retirees over 70 years old, 80% of the expenses above 1300 yuan can be reimbursed. No matter what kind of people, the maximum payment limit for outpatient and emergency medical expenses is 20 thousand yuan;

2. The reimbursement ratio of residents' medical insurance outpatient service is the medical expenses incurred by insured patients in designated medical institutions, and they are directly settled at the residents' medical insurance settlement counter with special medical insurance prescriptions and social security cards. In an insurance year, if the total outpatient expenses are below 50 yuan, the medical insurance fund will pay 4O%, and the expenses above 50 yuan will be borne by individuals;

3, rural medical insurance outpatient reimbursement ratio:

(1) The medical expenses of village clinics and village center clinics are reimbursed by 60%, and the prescription drug fee limit for each visit is 10 yuan, and the prescription drug fee limit for temporary rehydration of doctors in health centers is 50 yuan;

(2) Reimbursement for medical treatment in town health centers is 40%, and each examination fee and operation fee are limited to 50 yuan, and the prescription fee is limited to 100 yuan;

(3) 30% reimbursement for medical treatment in secondary hospitals, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan;

(4) 20% reimbursement for medical treatment in tertiary hospitals, with each examination fee and operation fee limited to 50 yuan and prescription drug fee limited to 200 yuan;

(5) Prescription limit attached to traditional Chinese medicine invoice 1 yuan;

(6) The annual compensation limit for rural cooperative medical clinics is 5,000 yuan.

Legal basis:

Article 25 of People's Republic of China (PRC) Social Insurance Law

The state establishes and improves the basic medical insurance system for urban residents.

The basic medical insurance for urban residents combines individual contributions with government subsidies.

People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.