Proportion of reimbursement for children's medical insurance in Beijing

According to the relevant regulations of children's medical insurance, children who pay 100 yuan social insurance premium every year will be included in the medical insurance when they see a doctor, and those who exceed 650 yuan can be reimbursed. The reimbursement rate for outpatient service is 50, with the upper limit of 2,000 yuan, and the reimbursement rate for hospitalization is 70, with the upper limit of170,000 yuan. The part that can be reimbursed can be directly exempted by the parents of the child when they check out. If you don't stay in hospital, there will be no other reimbursement if you only exceed the upper limit of 8000. In April every year, you will be reimbursed for the serious illness with a relatively large amount of self-payment in the previous year. It is estimated that the out-of-pocket expenses will reach more than 45,000 next year.

The reimbursement for children's medical insurance in Beijing is divided into outpatient reimbursement and hospitalization reimbursement, of which the reimbursement standard for outpatient service is 650 yuan, accounting for 50% of the above reimbursement standard, the annual reimbursement standard for medical insurance is 1 10,000 yuan, the reimbursement standard for 650 yuan is 70%, and the annual reimbursement standard for medical insurance is 1.7 million yuan. The outpatient expenses of the insured children due to illness can be reimbursed (2000-650)*50%=675 yuan, and the outpatient expenses of 2000 yuan or 3500 yuan can be reimbursed (3500-650)*50%= 1425 yuan. An insured child who spends 30,000 yuan on medical expenses due to illness can be reimbursed (30,000-650) * 70% = 20,545 yuan; If you spend 55,000 yuan on medical expenses due to illness, you can reimburse (55,000-650) * 70% = 38,045 yuan. Tip: What is the reimbursement rate of children's medical insurance in Beijing? If it is a major outpatient disease reimbursement, the reimbursement rate above the deductible standard is 50%, the deductible standard is 650 yuan, and the annual payment limit of medical insurance is 2000 yuan. If it is hospitalization reimbursement, the deductible is above the standard, that is, the medical expenses exceed 70% of 650 yuan's reimbursement, and the maximum limit is 6,543,800 yuan+0.7 million yuan.

To sum up, according to the relevant provisions of children's medical insurance, children who pay 100 yuan social insurance premium every year can be reimbursed for the part that is included in medical insurance when they see a doctor, and the part that exceeds that of 650 yuan. The reimbursement rate for outpatient service is 50, with the upper limit of 2,000 yuan, and the reimbursement rate for hospitalization is 70, with the upper limit of170,000 yuan.

Legal basis:

People's Republic of China (PRC) social insurance law

Seventy-fourth social insurance agencies through business handling, statistics, investigation and other means to obtain the data needed for social insurance work, the relevant units and individuals should provide timely and truthful. The social insurance agency shall establish a file for the employer in a timely manner, completely and accurately record the social insurance data such as personnel's participation in social insurance and payment, and properly keep the original vouchers for registration and declaration and accounting vouchers for payment and settlement. The social insurance agency shall timely, completely and accurately record the individual's personal rights and interests such as social insurance payment, employer's payment and social insurance benefits, and regularly send the personal rights and interests records to me free of charge. Employers and individuals can inquire and check the records of payment and social insurance benefits from social insurance agencies free of charge, and ask social insurance agencies to provide social insurance consultation and other related services.