The reimbursement ratio of medical insurance in Dongying City is formulated by Dongying Medical Insurance Center and adjusted according to the relevant national policies and the actual situation in Dongying City. According to the information released by Dongying Medical Insurance Center, the current reimbursement rate of medical insurance in Dongying is 70% to 90%, including 70% for basic medical insurance and 90% for serious illness insurance. Specifically, Dongying basic medical insurance can reimburse some medical expenses, of which the reimbursement ratio is 70%, including medicine expenses, diagnosis expenses, treatment expenses, operation expenses and nursing expenses. According to the medical insurance catalogue, outpatient/hospitalization and other different situations, the reimbursement ratio is different. For example, the reimbursement expenses for outpatient and inpatient medical insurance for urban workers are different, but they are both 70%. Dongying City's critical illness insurance is the guarantee of the insured's treatment expenses for major diseases, and the reimbursement ratio is 90%. The specific reimbursement content includes hospitalization medical expenses, medicine expenses, operation expenses, radiotherapy and chemotherapy expenses. However, it should be noted that critical illness insurance has a certain reimbursement limit, and the part that exceeds the limit needs to be borne by itself.
What medical expenses does Dongying medical insurance not cover? In medical insurance coverage, Dongying City, some medical expenses will not be reimbursed, such as cosmetic surgery, health care service fees, and expenses arising from illegal medical practice. In addition, there are some special medical expenses, such as some special drugs and high-end items, which may not be covered by medical insurance. Users should pay attention to these situations when using medical insurance.
The proportion of medical insurance reimbursement in Dongying city is determined according to the medical insurance catalogue, outpatient service/hospitalization and other different situations, and it is divided into basic medical insurance and serious illness insurance. The specific reimbursement standard is formulated by Dongying Medical Insurance Center, and the insured should pay attention to their own medical insurance scope and reimbursement ratio when using medical insurance.
Legal basis:
Article 14 of the Social Medical Insurance Law, the sources of financing for the basic medical insurance fund include: contributions from insured persons, government subsidies, interest on personal accounts and other legitimate income.