Newborn baby health insurance off-site reimbursement rate

The reimbursement rate for newborns' off-site medical insurance is 60%-70%. In a billing year, incurred in line with the scope of reimbursement of medical expenses of less than 100,000 yuan, the starting standard for tertiary hospitals is 659 yuan, the reimbursement rate is 50% up to 2,000 yuan; secondary hospital hospitals hospitalization starting standard is 300 yuan, the reimbursement rate is 55%; first-class hospitals do not have a starting standard, the reimbursement rate is 60%.

Medicare reimbursement can be made as follows:

1. If you are hospitalized in a designated medical institution, you will be discharged from the hospital with your medical card and ID card, and will be directly billed and accounted for at the billing window of the designated hospital;

2. If you are undergoing medical treatment in a different place, you will call the social security bureau of the place of your participation within three days of admission to the hospital, make a filing for the record and register, and then return to the local social security bureau within one month to for reimbursement.

The conditions for reimbursement of medical insurance are as follows:

1. Newly insured and re-insured employees who have interrupted their contributions for more than one year to participate in basic medical insurance in accordance with the law and have made contributions for six consecutive months are entitled to basic medical insurance treatment according to the regulations;

2. Those who have made contributions for less than six consecutive months are not entitled to basic medical insurance treatment;

3. Those who have interrupted their contributions for less than one year are After re-enrollment and payment of contributions to enjoy the treatment in accordance with the provisions;

4, interruption of payment of contributions during the interruption does not enjoy the basic medical insurance treatment.

In summary, the newborn's medical insurance is generally in accordance with the proportion of reimbursement, according to the reimbursement of the proportion of 60% to 70% ranging.

I hope the above can help you, if you have other questions please consult a professional lawyer.

Legal basis

The Chinese people*** and the State Social Insurance Law, Article 28

In line with the basic medical insurance drug catalog, diagnostic and treatment items, medical service facilities standards, as well as emergency, rescue medical expenses, in accordance with state regulations from the basic medical insurance fund.

Article 29

The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.

The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.