Policy and scope of medical insurance reimbursement in different places in Guizhou Province

Settlement of medical treatment in different places in Guizhou Province-reimbursement scope of medical insurance in different places

First, the insured who seek medical treatment in different places in the province must hold a social security card issued by the whole province.

Two, off-site general outpatient (emergency) outpatient, pharmacy to buy drugs:

1. Insured personnel can use their social security cards to directly swipe their cards in hospitals or pharmacies that have opened medical services in different places in the province, without going through the formalities.

2. If there is a balance in the personal account of the insured, it shall be settled by the social security agency of the place where the medical treatment is sought and the hospital or pharmacy; If no personal account has been established or the balance of personal account is insufficient, I will pay in cash.

Third, hospitalization in different places:

1, the insured person must go through the medical treatment procedures in different places at the social insurance agency of the insured place according to the regulations.

2, the insured can only choose different hospitals in different designated medical institutions announced in the overall planning area.

3. The settlement standard shall be implemented according to the treatment policy of the insured place. The insured only needs to pay the personal cash burden to the hospital, and the part that should be paid by the fund is settled by the social security agency of the medical place and the hospital.

Four, the social security card of medical personnel in different places is lost or damaged, and must be re-applied at the insured place.

Five, the overall regional consultation telephone:

Guizhou Provincial Social Security Bureau: 085 1-,

Guiyang medical insurance center: 085 1-,

Zunyi Social Security Bureau: 085 1-,

Bijie Social Security Bureau: 0857-,

Tongren city Social Security Bureau: 0856-,

Liupanshui Social Security Bureau: 0858-,

Anshun Social Security Bureau: 085 1-

Qiannan Social Security Bureau: 0854-,

Qiandongnan Social Security Bureau: 0855-

Qianxinan Social Security Bureau: 0859-

Gui 'an New District Housing Provident Fund and Social Security Service Center: 085 1-

Six, the list of designated medical institutions and pharmacies in the overall planning area can be found in the column of Guizhou Human Resources and Social Security Network for medical treatment in different places.

Guiyang Medical Insurance Reimbursement Guide

Reimbursement ratio

Reimbursement of hospitalization medical expenses:

Qifubiaozhun and reimbursement ratio of basic medical insurance for urban workers;

1, medical insurance for employees on the job

(1) Threshold fee for first hospitalization: 700 yuan;

(2) Threshold fee for the second hospitalization: 500 yuan;

(3) Threshold fee for the third hospitalization: 420 yuan;

The reimbursement rate is: 70%.

2. Retiree medical insurance

(1) Threshold fee for first hospitalization: 500 yuan;

(2) Threshold fee for the second hospitalization: 350 yuan;

(3) Threshold fee for the third hospitalization: 300 yuan;

The reimbursement rate is: 75%-80%.

3. Flexible employment medical insurance

(1) Threshold fee for first hospitalization: 700 yuan;

(2) Threshold fee for the second hospitalization: 500 yuan;

(3) Threshold fee for the third hospitalization: 420 yuan;

The reimbursement rate is: 70%.

1, and the number of hospitalizations refers to the number of hospitalizations in that year;

2. The threshold fee is not within the scope of reimbursement;

3, enjoy the civil service Medicaid insured according to the provisions of the state pays part of the subsidy.

Urban residents' medical insurance, college students' medical insurance and new rural cooperative medical insurance in Wangcheng County: minimum payment standard and reimbursement ratio;

1, medical insurance for urban residents:

(1) Threshold fee for first hospitalization: 700 yuan;

(2) Threshold fee for the second hospitalization: 500 yuan;

(3) Threshold fee for the third hospitalization: 420 yuan;

The reimbursement rate is: 70%.

2. Medical insurance for college students:

(1) Threshold fee for first hospitalization: 700 yuan;

(2) Threshold fee for the second hospitalization: 500 yuan;

(3) Threshold fee for the third hospitalization: 420 yuan;

The reimbursement rate is: 70%.

3, the new rural cooperative medical insurance:

(1) threshold fee for first hospitalization: 1000 yuan;

(2) Threshold fee for the second hospitalization: 0 yuan;

(3) Threshold fee for the third hospitalization: 0 yuan;

The reimbursement rate is: 70%.

1, and the number of hospitalizations refers to the number of hospitalizations in that year;

2. The threshold fee is not within the scope of reimbursement;

3. The new rural cooperative medical system: The lump sum price for internal hemorrhoids, external hemorrhoids and mixed hemorrhoids is 2300 yuan, and individuals only need to pay 690 yuan.

Outpatient medical expenses reimbursement:

Urban residents:

Every time 30 yuan's "threshold fee" is deducted, the rest of the fees will be settled according to the regulations. After the "threshold fee" reaches 200 yuan, it will not be collected.