Scope and proportion of reimbursement for children's medical insurance

According to the "How much is the reimbursement for children's medical insurance" published by Inquiry.com, the scope and proportion of reimbursement for children's medical insurance are as follows:

1, hospitalization medical insurance benefits. Within one year, the hospitalization medical expenses below 6.5438+0.8 million yuan, and the first-class hospital (community health service center) does not set the deductible line, and it will be reimbursed by 65%. 300 yuan, the deductible line of the second-level hospital, will be reimbursed 60% of the expenses. 500 yuan, the deductible line of tertiary hospital, will be reimbursed by 55%.

2, outpatient special disease reimbursement treatment. The deductible line for outpatient special diseases within one year is 300 yuan, and the highest payment limit and reimbursement ratio are implemented according to the hospitalization reimbursement standard. Special outpatient diseases include: renal dialysis, anti-rejection after renal transplantation, tumor radiotherapy and chemotherapy analgesia, diabetes, cor pulmonale, lupus erythematosus, hemiplegia, psychosis, hemophilia, anti-rejection after liver transplantation, epilepsy, aplastic anemia and chronic thrombocytopenic purpura.

3, emergency reimbursement treatment. Within one year, the deductible line of emergency medical expenses incurred by urban and rural residents in first-class hospitals (including community health service centers) is 800 yuan, with the maximum payment limit of 3000 yuan and 30% subsidy.

4. Additional insurance benefits for students' accidental injuries. On the basis of the basic medical insurance for urban and rural residents, a unified supplementary insurance for accidental injuries of students and children will be established to solve the problems of medical expenses compensation, disability and death subsidies for students and children due to accidental injuries.

In terms of insurance organization, school and kindergarten students and children are insured by schools and kindergartens, which go through the insurance formalities in the social security sub-centers in their districts and counties, and the municipal student medical insurance service center provides assistance. Children who are not enrolled in urban schools or kindergartens shall go through the insurance formalities with their families at the labor and social security service centers and community workstations in the streets and towns where their household registration is located or where they often live. For children who are not enrolled in schools or kindergartens in rural areas, the administrative village shall be used as a unit to organize the insurance.