Proportion of reimbursement for medical treatment in Xiamen social security card in different places

The reimbursement rate of Xiamen social security card for medical treatment in different places is as follows:

1. Outpatient medical expenses: medical insurance fund pays 70%, and individuals pay 30%. The proportion of medical insurance fund payment for medical treatment in different places is 40%. The individual pays 60%.

2. Hospitalization medical expenses: for those hospitalized in designated medical institutions in Xiamen, the proportion of medical insurance fund payment is 80%, and the proportion of individual payment is 20%. In medical institutions in different places, the proportion of medical insurance fund payment is 60%, and the proportion of individual payment is 40%.

Conditions for reimbursement of medical insurance in different places:

1, participation status: reimbursement for medical insurance in different places is only applicable to those who participate in medical insurance systems such as urban workers' basic medical insurance, urban and rural residents' basic medical insurance and new rural cooperative medical care;

2. Payment record: when applying for reimbursement in different places, the applicant must have paid the medical insurance fee and meet the requirements of payment time and standard;

3. Reimbursement scope: policies such as reimbursement scope and reimbursement ratio of medical insurance in different places shall be subject to the relevant policies and regulations of the insured place. It should be noted that medical insurance reimbursement policies may be different in different regions, and applicants need to handle them according to local policies and regulations;

4. Hospital selection: When seeking medical treatment in different places, the applicant must choose a designated medical institution for medical insurance, otherwise he will not be able to enjoy medical insurance reimbursement;

5. Reimbursement application materials: Applicants need to prepare complete reimbursement application materials, including medical bills, expense lists, medical treatment certificates in different places, and reimbursement application forms.

To sum up, the reimbursement proportion and scope of medical insurance reimbursement in different places may also be different, and the reimbursement proportion of medical insurance reimbursement in different places may be lower than that of local medical insurance reimbursement. Please consult the local medical insurance department for details.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.