Is hospitalization in Jiangsu reimbursed by self-funded medical insurance?

Employee social insurance reimbursement

1, hospitalization expenses according to regulations:

◆ Tertiary hospitals: The medical expenses of tertiary medical institutions are less than 1 10,000 yuan (including 1 10,000 yuan) when they leave the hospital, 84% of which are paid by the on-the-job employee pooling fund and16% by individuals; Medical expenses 1 10,000 yuan to 40,000 yuan (including 40,000 yuan), 88% paid by the overall fund, and the individual pays 1.2% (the individual pays 50% of the above standard, the same below);

◆ Hospitals below Grade II: In Grade I and Grade II medical institutions, the medical expenses of on-the-job employees are below 6,543.8+0,000 yuan (including 6,543.8+0,000 yuan), 88% is paid by the overall fund, and the individual pays 654.38+0.2%; Medical expenses 1 0,000 yuan to 40,000 yuan (including 40,000 yuan), 90% paid by the overall fund, and 0/0% paid by individuals (50% paid by retirement);

◆ Community hospital: discharged from the community health service center for settlement, with medical expenses below 40,000 yuan (including 40,000 yuan), 92% paid by the overall fund and 8% paid by individuals (half paid for retirement);

2. Large expenses: the proportion of medical expenses above 40,000 yuan paid by the fund and paid by individuals is 92% and 8% respectively.

3. initial hospitalization fee: the first hospitalization fee (threshold fee) is required. The tertiary hospital is working in 950 yuan and retiring in 750 yuan; The second-level hospital is working in 750 yuan, retiring 600, the first-level hospital is unified as 400 yuan, and the community health service center is unified as 300 yuan. During the year, the second hospitalization was 50% of the above standard, and the third and above hospitalization was 25% of the above standard.

Social security card has the difference between outpatient service and hospitalization.

Outpatient expenses are deducted from personal accounts,

The hospitalization expenses are deducted from the overall medical insurance account.

The reimbursement amount of each hospital is different.

The better the hospital, the less reimbursement.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.