Can social security reimburse outpatient expenses?

Outpatient expenses are also reimbursed.

Scope of use of medical insurance card

First, outpatient and emergency expenses.

1. The medical expenses above 1800 yuan can only be reimbursed after the on-the-job employees see a doctor in the emergency department of the hospital, and the reimbursement rate is 50%.

2. Retirees under the age of 70,1.Expenses above 300 yuan can be reimbursed, and the reimbursement rate is 70%.

3. Retirees over 70 years old,1.Expenses above 300 yuan can be reimbursed by 80%.

Second, the hospitalization expenses.

The maximum annual payment limit (hospitalization expenses) of the basic medical insurance pooling fund is currently 70,000 yuan.

1, the standard of hospitalization reimbursement is related to the level of the hospital where the insured person is located. If you live in a tertiary hospital, the employee will pay 15%, that is, 85%, from the minimum payment standard to 30,000 yuan.

Expenses ranging from 23,000 yuan to 40,000 yuan are paid by employees themselves 10% and reimbursed by 90%.

3, more than 40000 yuan to the maximum payment limit, 95% can be reimbursed, employees only need to pay 5%.

4. The individual contribution ratio of retirees is 60% of the on-the-job (i.e. the above) employees, but all below the threshold is paid by individuals.

Three, designated hospitals and retail pharmacies

Reimbursement scope of designated hospitals and retail pharmacies: The insured can only be reimbursed if he visits four designated medical institutions (except emergency) or designated Chinese medicine and specialties (including stomatological hospitals, maternity hospitals, cancer hospitals, etc.). ) and 1 1 Class A medical institutions.

I hope the above content can help you. Please consult a professional lawyer if you have any other questions.

Legal basis: Article 8 of the Regulations on the Administration of Social Insurance Premium Declaration and Payment.

The employing unit shall, within 30 days from the date of employment, register social insurance for employees and declare and pay social insurance premiums. If the social insurance has not been registered, the social insurance agency shall verify the social insurance premium it should pay. If the employer fails to declare the amount of social insurance premiums payable according to the regulations, the social insurance agency shall temporarily determine the amount payable according to 1 10% of the amount paid by the unit last month; If there is no payment amount last month, the social insurance agency shall temporarily determine the amount of payment according to the operating conditions of the unit, the number of employees and the average salary of employees in the local last year. After the employer completes the declaration procedures, the social insurance agency shall settle the accounts in accordance with the provisions.