Proportion of outpatient reimbursement in designated hospitals in Jiangmen City

The proportion of outpatient reimbursement in designated hospitals in Jiangmen City is determined according to the agreement signed between residents' medical insurance fund and the hospital, which is generally divided into three grades, 90%, 80% and 70% respectively.

The proportion of outpatient reimbursement in Jiangmen designated hospitals refers to that when residents are treated in designated hospitals in this city, the medical insurance fund can reimburse patients' medical expenses according to a certain proportion. The proportion of outpatient reimbursement in designated hospitals in Jiangmen City is determined according to the agreement signed between residents' medical insurance fund and the hospital, which is generally divided into three grades, 90%, 80% and 70% respectively. Among them, 90% of outpatient reimbursement is applicable to urban residents' basic medical insurance participants and rural residents who are insured after the merger of the new rural cooperative medical system; 80% of outpatient reimbursement rate is applicable to residents who have not participated in the basic medical insurance for urban residents but have purchased serious illness insurance; 70% of the outpatient reimbursement rate is applicable to residents who have not participated in the basic medical insurance for urban residents or purchased serious illness insurance. It should be noted that different hospitals may be different when signing agreements, so the specific outpatient reimbursement ratio also needs to refer to local medical insurance policies and hospital regulations. In addition, for some special diseases or treatment projects, there may be special provisions on the proportion of outpatient reimbursement in Jiangmen designated hospitals.

I heard that Jiangmen also has a social security card. What's the difference between social security card and resident medical insurance card? Jiangmen's social security card refers to the basic medical insurance for urban workers, the basic medical insurance for urban residents and the new rural cooperative medical insurance, and can be settled by credit card. Residents' medical insurance cards only contain residents' medical insurance information and can only be used in designated medical insurance institutions. The scope of use and functions of the two are different, but they are both for the convenience of the insured for medical treatment and settlement.

The proportion of outpatient reimbursement in Jiangmen designated hospitals aims to help residents reduce the burden of medical expenses. The specific proportion needs to refer to local medical insurance policies and hospital regulations. At the same time, citizens should choose to buy social security cards or residents' medical insurance cards according to their own conditions in order to better enjoy the corresponding medical insurance.

Legal basis:

"People's Republic of China (PRC) Social Insurance Law" Article 36 The social insurance agency shall conclude a cooperation agreement or cooperation agreement with the medical institution, and announce the cooperation. The payment standard of social insurance fund shall be determined through consultation between social insurance agencies and medical institutions.