Guangzhou medical insurance card how to reimbursement ratio

Guangzhou medical insurance designated hospitals refers to the social security department announced the jurisdiction of the region with the social security medical qualifications of the hospital list, according to the published list, the insured person selected their own hospital, and then the social security department after examination and approval of the qualified, issued to participate in the medical insurance personnel medical insurance card, medical insurance card to the designated hospitals to get medical treatment, can be in accordance with the relevant provisions of the reimbursement of medical expenses, otherwise can not be reimbursed for the cost of medical care.

Hospitals are divided into Class A and Class B hospitals. Category A hospitals are further divided into first class, second class and third class.

Generally speaking, each person can choose two designated hospitals for medical insurance, including one compulsory community hospital.

Guangzhou designated hospital hospitalization reimbursement ratio hospitalization reimbursement - low starting standard, **** payment section of the integrated fund proportion is the highest, the individual payment proportion is the lowest

Selected point of the health insurance unit level is different, hospitalization of the starting line, the amount of reimbursement of the integrated fund, the amount of individual payment are very different. Guangzhou Ren'ai Tianhe Hospital is classified as a level 1 hospital (also known as community service organization) of medical insurance standard, which can enjoy the technology and service standard of tertiary hospitals, and at the same time, it is also the hospital with the lowest hospitalization starting payment standard, the ****payment section of the co-ordinated fund with the highest payment ratio, and the lowest individual payment ratio. The hospitalization reimbursement ratio of first-class hospitals: the minimum hospitalization starting line is 200 yuan, and the maximum starting line is 400 yuan

The maximum reimbursement with the coordinated fund is 90%, and the individual needs to pay only 10%

The hospitalization reimbursement ratio of second-class hospitals: the minimum starting line reaches 400 yuan, and the maximum starting line is 800 yuan

The maximum reimbursement with the coordinated fund is 85%, and the individual needs to pay 15%

Tertiary hospital inpatient reimbursement rate: the minimum starting line reaches RMB 800, and the maximum starting line is RMB 1,600

The maximum reimbursement with the centralized fund is 80%, and the individual needs to pay 20%

Hospitalization medical insurance formula

Hospitalization medical insurance formula (for example, RMB 1,000):

Formula 1: hospitalization starting line + (1000 - hospitalization starting line) × individual payment ratio = out-of-pocket expenses to be paid by the individual

Formula 2: (1000 - hospitalization starting line) × coordinated fund payment ratio = expenses reimbursed by the coordinated fund

Warm reminder: in the case of inpatient medical expenses, the individual should be responsible for the following costs:

Out-of-pocket expenses;

Prior out-of-pocket expenses (i.e., expenses within the scope of the three catalogs of medicines, diagnostic and therapeutic items, and medical service facilities, which stipulate that the participant should pay the proportion of the first part of the expenses out-of-pocket)

Expenses below the starting standard;

**Payment of out-of-pocket expenses;

Excesses of expenses over the maximum limit of the payment of the medical subsidy for major illnesses

<

Reference:

Expanded reading: insurance how to buy, which is good, and hand to teach you to avoid insurance These "pits"