Linyi Hedong second reimbursement for major illnesses where to report

Reimbursement at the Hedong District Social Security Bureau. Medical insurance secondary reimbursement process:

1, outpatient, emergency costs of reimbursement of large medical mutual aid (outpatient, emergency) starting line amount of 2000 yuan for active employees, retirees for 1300 yuan. If the accumulated outpatient and emergency expenses in a year are less than 2,000 yuan for employees and 1,300 yuan for retirees, the participants will pay from their individual accounts. If the amount above the starting line is reached in a natural year, the large medical mutual aid system can be applied.

2. The reimbursement of hospitalization expenses is in accordance with the regulations. At present, when the basic medical insurance is used to pay for hospitalization expenses for the first time in a year, the starting line amount for both active and retired persons is 1,300 yuan. For the second and subsequent hospitalization expenses, the threshold is set at 50% and is RMB 650. The maximum payment from the Basic Medical Insurance Co-ordination Fund (for hospitalization expenses) is currently 70,000 RMB in one year. The individual payment rate for retirees is 60% of the individual payment rate for active employees, but the same portion below the starting standard is all paid by the individual. The rate of reimbursement for hospitalization is related to the level of the medical institution where the participant is admitted. Note: There are two thresholds for outpatient and hospitalization.

3. If a participant's hospitalization expenses are more than the maximum payment limit, the excess will be reimbursed according to the relevant standards of the Large Medical Mutual Aid, i.e., 70% will be paid by the Large Medical Mutual Aid Fund and 30% by the individual. Within one year, the cumulative maximum payment amount for large medical mutual aid is 100,000 yuan.