Proportion of medical insurance reimbursement for employees in Guangzhou in 2022

1.What is the proportion of medical insurance reimbursement in 2022?

Medical insurance is mainly divided into employee medical insurance and resident medical insurance, and the reimbursement ratio is also different. According to the level of hospitalization expenses, the reimbursement rate of medical insurance for employees is 85% between 1300 yuan and 30,000 yuan, 90% between 30,000 yuan and 40,000 yuan, 95% between 40,000 yuan and10000 yuan, and 85% between10000 yuan and 300,000 yuan. Residents' medical insurance consists of urban residents' medical insurance and the new rural cooperative medical system. The reimbursement rate is: 65% of the first-class hospital, and the deductible line is

Three hundred yuan; The reimbursement rate of secondary hospitals below 6,000 yuan is 65%, and the reimbursement rate of hospitals above 6,000 yuan is 80%. The deductible line of county-level hospitals is 400 yuan, and the deductible line of municipal hospitals is 600 yuan. Third-level hospitals and county third-level hospitals pay in 600 yuan, and the reimbursement rate is 65%. The reimbursement rate of more than 6000 yuan is 80%, and the deductible line of the municipal tertiary hospital is 800 yuan. 12000 yuan, the reimbursement rate is 55%. 1.2 million yuan or more, the reimbursement rate is 75% higher than that of optical fiber coverage.

Second, the composition of medical insurance and the scope of reimbursement

At present, the basic medical insurance system in China includes the basic medical insurance for urban workers, the new rural cooperative medical system and the basic medical insurance for urban residents.

Composition of medical insurance = basic medical insurance+supplementary medical insurance (large medical mutual fund)

Basic medical insurance = individual account+overall fund

Personal accounts are generally composed of three parts, namely, medical insurance premiums paid by insured individuals, basic medical insurance premiums paid by employers and distributed according to a certain proportion, and interest income.

Personal accounts can pay the following fees:

1, outpatient and emergency medical expenses;

2, to the designated retail pharmacies to buy drugs;

3, the basic medical insurance fund Qifubiaozhun below the medical expenses;

4, more than the basic medical insurance fund Qifubiaozhun, according to the proportion that should be borne by the individual medical expenses;

The part of the personal account that is not enough to pay shall be paid by myself.