Beijing Cancer Social Insurance Reimbursement Rate

Hello:

Let me give you a detailed explanation.

If you participate in social security, you will have up to three accounts: the general fund account (belonging to the public **** fund, everyone is the same), the large mutual account (you decide whether to set up), and personal account (high contribution salary is high personal account balance). In general, the contribution is borne by both the individual and the organization***, and for freelancers like you, you may have to bear the cost of social security yourself.

Now let's take a look at the different roles of each of the three accounts - that is, the scope of payments from each account.

First, there's the General Fund, which doesn't care about general outpatient care. It is mainly responsible for reimbursement of special outpatient and hospitalization expenses. The special outpatient reimbursement refers to the reimbursement of treatment costs incurred for radiotherapy and chemotherapy for cancer and dialysis for uremia, excluding surgical costs. Inpatient reimbursement refers to general hospitalization and the first seven days of hospitalization following an emergency.

Secondly, if we look at the large amount of mutual aid, it is reimbursed for general outpatient services. In the case of special outpatient and hospitalization, the large amount of mutual aid reimbursement is for expenses exceeding the reimbursement ceiling of the integrated fund within a year (we'll talk about the costs below).

Finally, there is the personal account, which is free to spend as long as there is a balance in the personal account, which in a nutshell means spending your own money.

Let's now look at the reimbursement rules for each account.

The General Fund, which does not reimburse for general outpatient services, and the Special Outpatient and Hospitalization Reimbursement Program, which provides for reimbursement of 85% to 97% of the total costs of a hospital stay, has a starting line of 1,300 yuan. The annual cumulative cost ceiling is 70,000 yuan. The reimbursement rate is inversely proportional to the level of the hospital and directly proportional to the amount of medication prescribed. The higher the cost, the higher the reimbursement rate. For example, for a tertiary hospital in Beijing (the city divides hospitals into three levels, with tertiary being the highest), the reimbursement rate for medicine costs of 1,300-30,000 yuan is 85 percent; for 30,000-40,000 yuan, it's 90 percent; and for 40,000 yuan or more, it's 95 percent.

The large amount of mutual aid this piece, general outpatient starting line is 2000 (equivalent to the deductible), more than 2000 reported 50%, up to 20,000 can be reported. Special outpatient and hospitalization reimbursement, it reimburses the part of the cost that exceeds the ceiling line (70,000) of the integrated fund, 70%, up to 100,000 yuan.

The personal account is discretionary. The monthly income of the personal account is 2% of the individual's salary + 0.8% - 4.8% of the individual's salary from the enterprise.

In Beijing, the monthly income from personal account is 2.8% of one's salary for those under 35; 3% of one's salary for 35-44; 4% of one's salary for 45-retirement; 6.3% of one's salary for retirement-69; and 6.8% of one's salary for more than 79.

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