Yi Lao Xiao Yi insurance Ding Dian hospital

Beijing citizens, the elderly and children have social security; Let me explain the reimbursement method of one old and one small insurance;

For example, the hospitalization expenses of the elderly in a town are 50,000 yuan, and the reimbursable amount is: (50,000-1.300) × 60% = 29,220 yuan.

The threshold for reimbursement of serious illness for students and infants is 650 yuan. If the medical expenses exceed this amount, 70% will be reimbursed and the remaining 30% will be borne by itself. The maximum cumulative payment in a medical insurance year is 6.5438+0.7 million yuan.

For example, an insured child spent 6,543,800 yuan in the hospital, and the amount that can be reimbursed is: (100000-650)×70%=69545 yuan.

What are the restrictions on the scope of medical insurance reimbursement?

According to the provisions of the Municipal Labor and Social Security Bureau, the expenses that the elderly can reimburse are as follows:

1. Urban elderly medical insurance for serious illness mainly pays hospitalization expenses;

2. Outpatient medical expenses for taking anti-rejection drugs after radiotherapy and chemotherapy, renal dialysis, kidney transplantation or combined liver and kidney transplantation for malignant tumors;

3. Medical expenses within 7 days before emergency observation and hospitalization.

In addition, on the basis of the above, the reimbursement scope of medical insurance for students and children with serious illness also includes outpatient medical expenses for hemophilia and aplastic anemia.

How much does each side pay?

The medical insurance for serious illness of the elderly in cities and towns raises funds per person per year 1.400 yuan, of which the financial subsidy is1.654,38+0.000 yuan.

Medical insurance for serious illness of students and children is raised at 100 yuan per student per academic year, and individuals or families pay 50 yuan, with financial assistance to 50 yuan.

How many designated hospitals can I choose?

The insured elderly, students and children can choose 3 general hospitals as their designated medical institutions within the city.

You can also go directly to the designated medical institutions in the city, such as Chinese medicine hospitals, specialized hospitals, and 16 3A hospitals, totaling more than 100 hospitals; Insured children can go to the designated children's hospital for medical treatment.

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