In 2023, the reimbursement ratio of outpatient medical insurance for employees in Nanjing is as follows

From June 65438+1 October1day in 2023, Nanjing implemented the medical insurance outpatient mutual assistance guarantee mechanism, which means that employees' medical insurance can reimburse outpatient expenses. What is the reimbursement rate of medical insurance for employees in Nanjing?

Proportion of outpatient medical insurance reimbursement in Nanjing in 2023

The following is the reimbursement ratio of medical insurance outpatient service for employees in Nanjing:

/kloc-40%-60% of the expenses below 0/000 yuan (inclusive); 1000 yuan (excluding)-5,000 yuan (including), and the fund pays 60%-85%; 5000 yuan (excluding)-1.5 million yuan (including), and the fund pays 65%-90%.

In addition, the outpatient co-ordination of Nanjing workers' medical insurance canceled the deductible standard, while the original outpatient co-ordination and outpatient chronic disease deductible standard (ranging from 600 to 2,200 yuan), the new outpatient co-ordination policy did not set the deductible standard, and the new outpatient co-ordination fee payment limit covered the original outpatient co-ordination and the original outpatient chronic disease fund payment limit, which was generally improved. The annual outpatient fee limit is increased from the original 3333 yuan10.2 million yuan to10.5 million yuan.

In addition, Nanjing's personal account entry policy will also be adjusted. From June 5438+ 10, 2023, it will be included in the basic medical insurance premiums paid by individuals in the personal accounts of on-the-job employees, and the inclusion standard is 2% of the base of my insurance payment.

From June 5438+ 10, 2023, the personal account of retired (retired) personnel will be transferred to the monthly quota according to the amount allocated in my personal account in February 2022; In 2023, the new retirees in that year will be transferred according to 5.4% of the pension in the month of retirement, which will be included in the quota in that month. If the employee's medical insurance insured person turns to retirement on the job, after going through the relevant formalities, the employee's medical insurance retiree's personal account will be included in the implementation measures from the next month.

Generally speaking, Nanjing has implemented the medical insurance outpatient mutual aid guarantee mechanism, which has improved the outpatient reimbursement treatment and reduced the burden of outpatient medical expenses for the insured. That's all. I hope it helps you.