Proportion of medical insurance reimbursement for employees in Hangzhou

The proportion of medical insurance reimbursement for employees in Hangzhou is different for different medical projects, generally between 70% and 90%.

Workers' medical insurance in Hangzhou has implemented urban-rural coordination, that is, workers and migrant workers enjoy the same treatment in medical insurance. In terms of the specific reimbursement ratio of medical insurance, Hangzhou implements the principle of "classified management and differential payment" and sets different reimbursement ratios for different medical items. Generally speaking, the proportion of medical insurance reimbursement for employees in Hangzhou is between 70% and 90%. For example, outpatient medical treatment, western medicine, Chinese patent medicine, inspection and other items can get 70% reimbursement rate, and ordinary hospitalization expenses can get 80% reimbursement rate; In terms of special treatment, such as organ transplantation and high-end medical equipment, 90% reimbursement rate can be obtained. It should be noted that different medical items also have different reimbursement limits and deductible lines. For example, the reimbursement limit for outpatient western medicine and Chinese patent medicine is 300 yuan/month, the reimbursement limit for outpatient examination is 200 yuan/time, and the hospitalization deductible is 65,438 yuan+0,000 yuan/year. At the same time, medical insurance also strictly controls drugs. Only when drugs are listed in the list of essential drugs or the national medical insurance drug list can medical insurance reimbursement be obtained.

Are there any restrictions for employees to enjoy medical insurance reimbursement? Yes, according to the regulations of Hangzhou, employees have some restrictions when enjoying medical insurance reimbursement. For example, employees are not allowed to enjoy other social insurance benefits while enjoying medical insurance benefits; In the process of graded diagnosis and treatment, employees must sign a family doctor service agreement in accordance with the requirements of residents' health records management; At the same time, employees who enjoy medical treatment in different places should comply with relevant regulations.

The reimbursement rate of employees' medical insurance in Hangzhou is between 70% and 90%. The specific reimbursement rate, limit and deductible line will depend on different medical items. When enjoying medical insurance reimbursement, employees need to abide by relevant restrictions; At the same time, drugs also need to meet relevant standards in order to obtain medical insurance reimbursement.

Legal basis:

Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities and emergency and rescue medical expenses standards, and shall be paid from the basic medical insurance fund in accordance with state regulations.