Proportion of reimbursement for children's medical insurance

Proportion of children's social security hospitalization medical insurance:

According to different levels of hospitals, the reimbursement of hospitalization medical expenses below 6.5438+0.8 million a year will be different. Specifically, the first-class hospital does not have a deductible line and can reimburse 65% of the hospitalization medical expenses; 300 yuan, the deductible line of secondary hospitals, can reimburse 60% of hospitalization medical expenses; 500 yuan, the deductible line of tertiary hospitals, can reimburse 55% of hospitalization expenses.

Although the coverage of medical insurance policy has been gradually improved in the process of reform, children have been included in the basic medical insurance in many areas, but the principle of "low security and wide coverage" of social medical insurance determines its characteristics of many protection restrictions and small coverage of drugs, especially all kinds of new diagnosis and treatment methods and new specific drugs, which are not only very expensive, but also belong to the category of self-financing

What is even more worrying is the uneven distribution of medical resources in China. Urban hospitals with high medical level often have the dilemma of "one bed is hard to find". Poor hospitalization environment and complicated reimbursement procedures for medical treatment all make people exhausted when they seek medical treatment.

On the other hand, children's immune system is not yet strong and their resistance is low. Compared with adults, they are more likely to be infected by germs. Moreover, the child's organ function has not yet developed well, and its adaptability is poor, which is the high incidence stage of the disease. Especially children aged 0 ~ 6 are prone to some minor illnesses, such as colds, coughs, pneumonia, bronchitis and so on. And the risk of hospitalization is also high.

legal ground

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

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits. Article 25 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.

skill

The above answer is only for the current information combined with my understanding of the law, please refer carefully!

If you still have questions about this issue, I suggest you sort out relevant information and communicate with professionals in detail.