Shijiazhuang medical insurance card fixed-point new regulations

Whether it is employee medical insurance or resident medical insurance, outpatient co-ordination has a limit on deductible. The part within Qifubiaozhun shall be borne by the insured, and the part between Qifubiaozhun and the maximum payment limit shall be reimbursed according to the proportional limit. Insured employees or residents choose different levels of medical institutions as their designated clinics, with different deductible periods and different reimbursement ratios.

According to the overall policy of medical insurance outpatient service for employees in Shijiazhuang, the deductible line of first-class and below medical institutions is 700 yuan, the deductible line of second-class medical institutions is 900 yuan, the deductible line of municipal third-class medical institutions is 1 000 yuan, and the deductible line of third-class medical institutions is 1, and 300 yuan. Qifubiaozhun above to the annual payment limit, insured workers can enjoy outpatient medical expenses in proportion to reimbursement. According to different levels of medical institutions, the reimbursement ratio is different: 90% for first-class and below medical institutions, 85% for second-class medical institutions and 80% for third-class medical institutions. The annual limit of the basic medical insurance fund to pay the outpatient medical expenses for common diseases is 1500 yuan for employees and 2,500 yuan for retirees.

Residents' medical insurance pooling fund qifubiaozhun for 200 yuan, 200 yuan and the following parts, paid by individual residents; For the above part of 200 yuan, 50% will be reimbursed by the overall fund and 50% will be borne by the individual. According to different diseases, set the annual cumulative reimbursement ceiling. The annual cumulative reimbursement ceiling standard is implemented according to the "Shijiazhuang Urban Residents' Basic Medical Insurance for Chronic Diseases and Outpatient Medical Expenses Annual Limit Reimbursement Standard Table", and the overall fund exceeding the ceiling will not be paid. Every time a chronic disease is added, the minimum threshold is increased by 200 yuan, and the maximum reimbursement amount is also increased accordingly.

However, employees who participate in medical insurance are not entitled to reimbursement in all medical institutions. They need to choose a medical institution as their designated clinic in advance.

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