Proportion of medical insurance reimbursement for new employees in Wuhan in 2023

The proportion of medical insurance reimbursement for new employees in Wuhan in 2023 is as follows:

1. On-the-job personnel: the proportion of payment from the overall fund of tertiary medical institutions is 86%, and the proportion of individual payment is14%; The proportion of overall fund payment of secondary medical institutions is 89%, and the proportion of individual self-payment is11%; The proportion of fund payment for first-class medical institutions is 92%, and the proportion of individual payment is 8%; The proportion of community health service center's overall fund payment is 92%, and the proportion of individual pays is 8%.

2. Retirees: the proportion of fund payment in tertiary medical institutions is 88%, and the proportion of individual payment is12%; The proportion of overall fund payment of secondary medical institutions is 9 1%, and the proportion of individual self-payment is 9%; The proportion of fund payment of first-class medical institutions is 94%, and the proportion of individual payment is 6%; The proportion of community health service center's overall fund payment is 94%, and the proportion of individual pays is 6%.

Conditions for reimbursement of employee's serious illness medical insurance:

1. Medical insurance type: Employee's serious illness medical insurance refers to the medical insurance type consisting of employee's basic medical insurance and serious illness insurance, so the applicant needs to confirm whether it meets the relevant medical insurance conditions;

2. Scope of disease: Medical insurance for employees with serious illness is usually only for specific disease scope, such as malignant tumor, pneumoconiosis, hepatitis, etc. Applicants need to determine whether their illness is within the scope of reimbursement;

3. Reimbursement ratio: The reimbursement ratio of employee's serious illness medical insurance is different from that of ordinary medical insurance, which is generally higher, but the applicant needs to know the specific reimbursement ratio and reimbursement upper limit;

4. Reimbursement time: The employee's serious illness medical insurance stipulates the time limit for reimbursement, and the applicant needs to apply for reimbursement within the specified time, otherwise the reimbursement effect may be affected;

5. Medical expenses: The medical insurance for employees with serious illness reimburses the medical expenses that meet the policy requirements. Applicants need to know the medical expenses they need to pay and apply for reimbursement according to the prescribed procedures.

To sum up, the reimbursement process of employees' serious illness medical insurance in different regions and units may be different, and the specific process shall be subject to the regulations of local social security agencies.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.