Reimbursement scope of social security card to see a doctor

The scope of reimbursement for medical treatment by social security card is as follows:

I. Outpatient:

1. Reimbursement scope: general outpatient and emergency expenses incurred by insured persons at the designated hospitals or specialized hospitals of medical insurance of their personal choices, Chinese medicine hospitals and hospitals of Class A. The outpatient expenses incurred by insured persons at the hospitals of their personal choices are as follows:

2.

2. Outpatient starting line: general outpatient and emergency expenses incurred in a natural year exceeding 1,800 yuan in total.

3. Reimbursement rate: 70% for hospitals and 90% for communities for the portion above 1800 yuan, and the ceiling line: 20,000 yuan.

4. Required documents: original ID card; original medical diagnostic certificate; original medical documents such as outpatient medical records, report cards of examination and test results; original receipts of general outpatient and emergency charges; original list of itemized outpatient expenses or original prescription (prescription is pasted on the back of the receipt according to the date).

5. Submission time: 1-10th of each month, the current month's fees to be submitted the following month, the current year's fees need to be submitted by January of the following year.

2. Hospitalization:

1. Reimbursement scope: hospitalization expenses incurred by the insured in the designated hospitals or specialized hospitals of medical insurance of personal choice, Chinese medicine hospitals and Class A hospitals.

2. Starting line for hospitalization: the starting line for the first hospitalization in a natural year is 1,300 yuan, and 650 yuan for each subsequent hospitalization.

3. Reimbursement rate: 90% for first-class hospitals, 87% for second-class hospitals, 85% for third-class hospitals, and a total of 300,000 yuan for hospitalization.

Social security card medical reimbursement scope of the social security card have to participate in the social security patients to health insurance fixed-point hospitals, specialized hospitals, the provisions of the Chinese medicine hospital or A . Class A hospitals for outpatient and emergency treatment and hospitalization costs, surgical costs. Generally, 90% of the cost of hospitalization is reimbursed in first-class hospitals and 87% in second-class hospitals. The urban health insurance coverage also includes the cost of some ECG, filming, CT and other tests.

Legal basis:

The People's Republic of China Social Insurance Law

Article 28 of the basic state medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as emergency, rescue medical expenses, in accordance with state regulations from the basic medical insurance fund.