Teacher retirement social security reimbursement rate

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The teacher's health insurance reimbursement ratio:

The starting standard, also known as the starting line, refers to the coordinated fund began to pay before the amount of medical costs that must be borne by the insured person in accordance with the regulations, that is, usually referred to as the coordinated fund to pay for the "threshold" fee; the maximum payment limit, that is, usually referred to as the coordinated fund to pay for the "ceiling line", that is, the coordinated fund to pay for the "ceiling line", that is, the basic medical costs that can be paid by the fund. The maximum payment limit, is usually referred to as the integrated fund to pay the "ceiling line", refers to the integrated fund can pay the maximum limit of basic medical expenses.

Participants in outpatient coordination, outpatient chronic diseases and hospitalization are responsible for the starting standard. The maximum payment limit of the integrated fund in a natural year is 180,000 yuan; there is no maximum payment limit for the medical aid fund for major diseases.

Specialized medical institutions for the insured patients to use the proportion of self-payment of Class B drugs or self-financed drugs, should inform and obtain the consent of the patient or his family, of which the proportion of self-payment of 30% (including 30%) or more of the drugs and self-financed drugs of Class B drugs must be signed by the patient or his family to be used (except for emergency rescue); without the signature of the patient or his family to be used, and the cost of which will be borne by the medical institutions.

Participants incurred basic medical insurance diagnostic and treatment items, the cost of medical service facilities, belonging to the scope of Category A catalog, according to the provisions of the basic medical insurance;

belonging to the scope of Category B catalog, the first by the participants in accordance with the prescribed proportion of out-of-pocket, and then pay the rest of the basic medical insurance; belonging to the scope of the Category C catalog, the basic medical insurance is not paid, the cost of All by the individual to take care of themselves.

Special medical material costs incurred by the insured in line with the scope of the basic medical insurance medical service catalog, where there is a ceiling on the payment of costs, the part above the limit shall be paid by the insured;

Costs within the limit shall be paid by the insured in accordance with the prescribed proportion, and the remaining part shall be paid in accordance with the provisions of the basic medical insurance; other special medical materials outside the scope of the basic medical insurance fund and medical care for the critically ill; the basic medical insurance shall not pay the costs, and all costs shall be paid by the individual. medical insurance fund and medical aid fund for major diseases are not paid.

Specified medical institutions for the use of participants in the proportion of out-of-pocket payments of 40% (including 40%) or more of the diagnostic and treatment items and special medical materials, as well as out-of-pocket payments for diagnostic and treatment items, special medical materials, must obtain the consent of the participants or their families (psychiatric patients must obtain the consent of the unit or the guardian), and sign the medical documents. The exception is the emergency rescue.