Proportion of hospitalization reimbursement for children born by residents' medical insurance

The proportion of reimbursement for children born by residents' medical insurance is as follows:

1, urban medical insurance reimbursement is generally 60%-80%. Those who have participated in maternity insurance can enjoy maternity insurance reimbursement; Outpatient prenatal examination medical expenses limit 500 yuan, the first prenatal examination fee 185 yuan;

2, delivery and delivery medical expenses quota standards, one-time reimbursement of tertiary hospitals 1500 yuan, secondary hospitals 1200 yuan, first-class hospitals 980 yuan, and so on.

Proportion of reimbursement for rural outpatient medical insurance:

1, 60% reimbursement for visits to village clinics and village center clinics, prescription drug cost limit for each visit 10 yuan, and prescription drug cost limit for temporary rehydration for doctors in health centers in 50 yuan;

2. 40% reimbursement for medical treatment in the town health center, with the limit of 50 yuan for each examination and operation, and the limit of prescription drug fee 100 yuan;

3, the secondary hospital reimbursement of 30%, each examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan;

4, tertiary hospital reimbursement of 20%, each visit examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan;

5. Chinese medicine invoice with prescription 1 yuan per paste;

6, the township cooperative medical outpatient compensation limit is 5000 yuan.

1。 When giving birth in hospital, you should bring your ID card and medical insurance card and make online reimbursement in designated medical hospitals.

2。 After delivery and discharge, the insured shall go through the examination and reimbursement procedures with his ID card, social security card, birth certificate, invoice of pregnancy examination expenses, invoice of maternity medical expenses and summary list of expenses to the medical insurance agency in the insured county;

3。 After the audit, the agency will pay the maternity medical expenses in accordance with the relevant laws and regulations to the insured residents.

I hope the above content can help you. If in doubt, please consult a professional lawyer.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

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.

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.