How to calculate the deductible line of medical insurance co-ordination

The calculation method of overall deductible of medical insurance is as follows:

1, calculated according to the policy: the deductible line of medical insurance is usually calculated according to the local medical insurance policy. Different levels of medical institutions and different medical expenses will have different deductible standards. For example, the deductible line of the first-level hospital may be 300 yuan, the second-level hospital may be 500 yuan, and the third-level hospital may be 700 yuan.

2. Cumulative calculation by year: the deductible line of medical insurance co-ordination can also be calculated by year, that is, in a natural year, the deductible line standard for multiple hospitalizations can be gradually reduced until it is reduced to 0. The specific calculation method may vary according to regions and medical insurance policies.

3. Calculation by disease type: The deductible line of medical insurance co-ordination can also be calculated by disease type, that is, different deductible standards are set according to different diseases. This method is usually to encourage the insured to give priority to primary medical institutions and reduce the burden of medical expenses.

There are two main types of medical security:

1, social medical security. Social medical insurance refers to medical insurance in social security, that is, everyone and unit pay a certain premium. Once you get sick, medical insurance can reimburse 50%-70% of medical expenses, and the rest will be paid by yourself.

2. Commercial medical insurance. That is, commercial insurance, how much to buy is up to you, and the remaining medical expenses can be reimbursed by medical insurance as a supplement; For those who have not purchased medical insurance, medical expenses in medical insurance coverage can be reimbursed.

To sum up, the overall deductible line of medical insurance is set to share the medical expenses reasonably, control the unreasonable growth of medical expenses, and ensure the basic medical needs of the insured.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.