Proportion of medical insurance reimbursement for Fuzhou employees 2023

The proportion of medical insurance reimbursement for employees in Fuzhou in 2023 is as follows:

1, outpatient reimbursement ratio standard:

(1) The reimbursement standard for medical treatment in the village center clinic is 60%;

(2) The reimbursement rate for medical treatment in town hospitals is 40%;

(3) The reimbursement rate of secondary hospitals is 30%;

(4) The reimbursement rate of tertiary hospitals is 20%.

2, hospitalization reimbursement ratio standard:

(1) Proportional standard for reimbursement of auxiliary examination expenses: reimbursement of examination expenses such as electrocardiogram, X-ray fluoroscopy, radiography, laboratory test, physiotherapy, acupuncture, CT and nuclear magnetic resonance;

(2) Proportion standard for reimbursement of operation expenses: refer to the national standard, if it exceeds 1 1,000 yuan, it will be reimbursed as 1 1,000 yuan; Older people over 60 years old are hospitalized in health centers and compensated for treatment and nursing expenses every day;

(3) The reimbursement rate standard of hospitals at all levels: the reimbursement rate of town hospitals is 60%; The reimbursement rate of secondary hospitals is 40%; The reimbursement rate of tertiary hospitals is 30%.

3, serious illness reimbursement ratio standard:

(1) Those who have participated in the medical insurance payment, and those whose serious illness reimbursement ratio is one-time or whose annual medical expenses exceed 5,000 yuan, will be compensated by stages;

(2) those who have participated in medical insurance payment, and the proportion of reimbursement for serious illness is one-time or the annual medical expenses exceed 5,000 yuan, and compensation is made in segments;

(3) For those who have participated in the medical insurance payment, the one-year reimbursement ratio limit for the compensation for hemodialysis and radiotherapy and chemotherapy in the town-level cooperative medical system hospitalization and uremia outpatient service.

Legal basis: Article 23 of the Social Insurance Law of People's Republic of China (PRC).

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.