How much is the hospitalization bed fee reimbursed by medical insurance?

After medical insurance hospitalization, the hospital bed fee can be reimbursed according to the prescribed amount, and the general bed fee in tertiary hospitals is basically within the prescribed amount. However, there will be a certain percentage of bed fees for advanced beds or private beds that exceed the regulations at their own expense.

Reimbursement standard of hospitalization bed fee for medical insurance

1. Payment standard of medical insurance for beds in general wards

The payment standard of medical insurance for beds in general wards of designated medical institutions shall be paid according to the bed standard of Class C wards, and the expenses beyond the bed standard of Class C wards shall be borne by the insured.

Project category charging standard medical insurance payment standard

General wards, secondary hospitals, first-class wards and hospitals independently determine the bed fee 32

There are 40 tertiary hospitals and Grade A wards, which are determined by the hospital independently.

Room 3732, Class B, Secondary Hospital

Class b ward of tertiary hospital 4540

Class C Ward 2222, A 3A Hospital

Room 3232, Class C, Secondary Hospital

Class C Ward of Tertiary Hospital 4040

Ward with more than 4 people in nursing home 18 18

Nursing Hospital 4-person Ward 2020

Nursing hospital 3-person ward 2420

Nursing Hospital 2-person Ward 3420

Nursing Hospital Single Ward 4420

2. Payment standard of medical insurance for bed fee in nursing inpatient ward

Pay according to the standard of 4 persons, and the expenses beyond the standard of 4 persons shall be borne by the insured.

Payment standard of medical insurance for bed fees in outpatient and observation rooms of first-class hospitals

Charge standard (yuan)

General emergency observation room level 2 15 15

Level 3 2020

Newly-built secondary emergency observation room 15 15

Level 3 2020

Materials required for reimbursement of hospitalization bed fee for medical insurance

1, valid identity document of the insured.

2, the insured medical insurance card or social security card

3. Pension

4. If you entrust others to handle it, you must also provide the valid identity certificate of the client.

Legal basis:

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

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.

Article 4 Employers and individuals who pay social insurance premiums according to law in People's Republic of China (PRC) have the right to inquire about payment records and personal rights and interests records, and ask social insurance agencies to provide social insurance consultation and other related services. Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.

Article 7 The administrative department of social insurance in the State Council is responsible for the management of social insurance throughout the country, and other relevant departments in the State Council are responsible for the relevant social insurance work within their respective functions and duties.

The social insurance administrative department of the local people's government at or above the county level shall be responsible for the social insurance management within its administrative area, and other relevant departments of the local people's government at or above the county level shall be responsible for the relevant social insurance work within their respective functions and duties.

Twenty-third 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.

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.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

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

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.

Article 28 of the Regulations on the Basic Medical Insurance for Urban Workers in People's Republic of China (PRC) is used to pay medical expenses beyond the scope of the overall fund; If the personal account is insufficient to pay, it shall be borne by me.