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How to stipulate the proportion of social security reimbursement in different places in Sichuan Province?
1, urban workers' basic medical insurance participants: 200 yuan, first-class hospital 400 yuan, third-class hospital 800 yuan, community health service center (including township hospitals) 160 yuan. 2. Urban and rural residents' basic medical insurance participants: first-class hospital 100 yuan, second-class hospital 200 yuan, third-class hospital 500 yuan, community health service center (including township hospitals) 100 yuan. 3, a natural year, the first category of diseases excluding Qifubiaozhun; Two or three kinds of diseases are counted as two Qifubiaozhun, which are reduced discontinuously; Calculation of the first payment standard for the fourth kind of diseases. Three. As long as the reimbursement conditions meet the relevant provisions of medical treatment in different places, the insured persons of basic medical insurance for urban workers and urban residents in Sichuan Province, and the participants of the new rural cooperative medical system managed by the human resources and social security departments have gone through the relevant procedures, they can enjoy the convenience of one-card settlement when they seek medical treatment in different cities (states) in Sichuan Province.
Medical insurance reimbursement process in Sichuan? For instant settlement of medical treatment in different places, the insured needs to hold a new social security card, that is, a second-generation social security card. The new social security card participants need to go through the relevant procedures such as medical treatment in different places at the insured place before they can settle the medical expenses in different places through the provincial platform. An instant settlement platform for medical treatment in different places of the province's basic medical insurance will be opened. With the new social security card, retirees living in different places will receive long-term placement and hospitalization, and the medical expenses will be settled in the hospital immediately, eliminating the tedious work of transmitting the information needed for medical insurance reimbursement from the hospital to the insured city.
The minimum payment standard is 88% when it is over 3,000 yuan, 95% when it is between 3,000 yuan and 5,000 yuan, 92% when it is 10000 yuan, and 95% when it is above the maximum payment limit.
Legal basis:
People's Republic of China (PRC) Social Insurance Law Article 25 The State establishes and improves the basic medical insurance system for urban residents.
The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.
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