Proportion of reimbursement for neonatal medical insurance in Chongqing

1. The annual settlement unit is general outpatient expenses. For outpatient expenses below 300 yuan, the fund pays 40%, that is, the maximum is 120 yuan/year. After the one-time settlement is completed, part of the expenses above 300 yuan need to be paid by individuals;

2. For outpatient expenses for serious diseases, such as hemophilia, aplastic anemia and systemic lupus erythematosus, the fund has no deductible, and the medical insurance fund pays 75%;

3, hospitalization expenses, according to the level of medical institutions to set different hospitalization Qifubiaozhun and fund payment ratio, taking tertiary hospitals as an example, the standard is above 500 yuan, and the fund payment ratio is 80%.

The qifubiaozhun for first-class hospitals (community health service centers), second-class hospitals and third-class hospitals are 0 yuan, 300 yuan and 500 yuan respectively. The reimbursement rates are 65%, 60% and 55% respectively.

Materials needed by Chongqing newborns for social security

(1) scope and time of insurance: newborns with local household registration can apply for insurance independently, and the time of independent insurance is within 90 days from the date of birth, and no later than September 30 of that year.

(2) Insurance mode: apply at the township (street) social security office where the newborn's household registration is located, and provide the original newborn household registration book and a copy of A4 paper (home page, personal page, increase and decrease page).

(3) Payment standard: it is divided into first grade and second grade. According to the regulations, those who declare before June 30 will only pay individual contributions, one file is 60 yuan, and the other file is 150 yuan; For those who apply after June 30th, the individual part and the subsidy part shall be paid together, with 340 yuan as the first file and 430 yuan as the second file.

(4) treatment enjoyment: if the newborn is insured within 3 months after birth, it will enjoy medical insurance benefits from the date of birth; Those who miss the insurance payment period will enjoy the residents' medical insurance benefits after 90 days from the date of payment settlement until June 65438+February 3 1 of that year.

Processing flow:

1. Mothers take the household registration book and copy the first page, home page and newborn page of the household registration book to the neighborhood committee to fill in the form.

2. Mothers take the household registration book, copy the first page, home page, newborn page and the application form filled out by the neighborhood Committee, go to the street where they live, and print the payment notice.

3. Mothers take the payment notice to the bank to pay (almost all state-owned banks can do it, but ask the neighborhood Committee specifically, and they will tell you whether to wait for the medical insurance card or take the temporary medical insurance card after asking the neighborhood Committee to pay). The cost should be 90 yuan 1 year.

Legal basis:

People's Republic of China (PRC) Social Insurance Law Article 25 The State establishes and improves the basic medical insurance system for urban residents.

The basic medical insurance for urban residents combines individual contributions with government subsidies.

People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.