Qingdao medical insurance reimbursement in 2023 what is the latest regulations

The latest regulations of Qingdao health insurance reimbursement in 2023 are as follows:

1. Reimbursement rate: 75% for primary medical institutions; 60% for secondary medical institutions; 50% for tertiary medical institutions;

2. Starting line: there is no starting line for outpatient reimbursement for primary medical institutions; the starting line for tertiary medical institutions is 500 yuan; the starting line for tertiary medical institutions is 800 yuan. The starting line is 800 yuan. Raise the maximum payment limit for outpatient medical insurance, adjust the annual payment limit for employees' general outpatient clinic to RMB 1,700 from 2023, and from 2023, using 5% of the average salary of the whole province as the calculation standard, it is expected to be raised to more than RMB 4,500.

The formalities and documents needed to apply for health insurance are as follows:

1, the hospitalization medical record issued by the attending doctor when the individual is hospitalized;

2, a list of the expenses required for hospitalization;

3, various invoices of the expenses required for hospitalization;

4, the discharge summary issued by the financial institution of the hospital;

5, the diagnosis of the disease issued by the attending doctor.

6, the ID card and household register of the person who seeks medical treatment;

7, the social security card of the person who seeks medical treatment.

In summary, the new health insurance policy in 2023 is mainly reflected in the following three aspects: more outpatient reimbursement, the annual limit of reimbursement increased, the general outpatient reimbursement rate increased, and reimbursement scope expanded to increase the number of items that could not be reimbursed before.

Legal basis:

Article 2 of the Social Insurance Law of the People's Republic of China

The state establishes a social insurance system of basic pension insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance, etc., and guarantees the right of citizens to obtain material assistance from the state and society according to the law in the case of old age, sickness, industrial injury, unemployment and maternity.

Article 26

The standards of treatment for basic medical insurance for workers, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the provisions of the State.

Article 28

Medical expenses that conform to the basic medical insurance drug catalog, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergencies and salvages, shall be paid out of the basic medical insurance fund in accordance with the state regulations.