Chengdu social security outpatient reimbursement ratio 2023

1. The reimbursement rate of outpatient service in Chengdu is: 200 yuan, a first-class hospital, 400 yuan, a third-class hospital, 800 yuan, a qualified community health service center (including township hospitals, the same below) that has signed an agreement with the medical insurance agency 160 yuan, and the threshold for referral outside the city is 2,000 yuan.

The reimbursement scope of Chengdu medical insurance is 1, and the outpatient expenses meet the requirements, including general outpatient service and outpatient treatment for serious and serious diseases; 2, in accordance with the provisions of the hospitalization expenses; 3. Medical expenses such as drug purchase expenses that meet the three catalogues; Iii. The reimbursement process of medical insurance in Chengdu is as follows: 1. The applicant submits the materials and accepts them; 2. Accept and complete the audit, settlement and payment; 3, the social insurance fund management bureau to review the materials and approve the application; The above is the relevant knowledge compiled by Bian Xiao. However, written knowledge is theoretical knowledge. In practice, it is necessary to analyze the proportion of social security reimbursement in Chengdu. If you have any questions, you can go to the relevant institutions for further consultation. If you have any other questions, please feel free to consult online. There are professional lawyers at your service.

Under any of the following circumstances, the minimum threshold can be reduced or exempted: (1); if the insured is hospitalized several times in a natural year, it will be reduced by 100 yuan, but the minimum is not less than 160 yuan; (2) The hospitalization expenses incurred by the insured in designated medical institutions due to mental illness or AIDS that meet the reimbursement scope of basic medical insurance are not included in the overall fund Qifubiaozhun; (3) 100 and above, the hospitalization expenses that meet the reimbursement scope of basic medical insurance due to illness in designated medical institutions are not included in the Qifubiaozhun of the overall fund; (4) The insured suffers from malignant tumor surgery, radiotherapy and chemotherapy, dialysis and transplantation of renal failure, anti-rejection treatment after liver, kidney and bone marrow transplantation, chronic leukemia and severe aplastic anemia. Myelodysplastic Syndrome, Myelodysplastic Diseases and Systemic Lupus Erythematosus have been hospitalized for many times in designated medical institutions, and those who meet the reimbursement scope of basic medical insurance shall be calculated once a year. Qifubiaozhun is determined according to the level of the designated medical institution where the insured person lives for the first time in the year;

Legal basis:

Social insurance law

Article 28

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.

Social insurance law

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.