Medical insurance for medical treatment in different places can also be reimbursed, but the proportion of medical insurance reimbursement for medical treatment in different places will be less than that in local areas.

1. What is the reimbursement rate for medical insurance in different places?

1, outpatient and emergency medical expenses: the medical expenses that met the requirements of the basic medical insurance in that year (1 10/February/31February) exceeded 2,000 yuan.

2. Settlement ratio: 50% of the part of the dispatched personnel above 2,000 yuan will be reimbursed during the contract period, and 50% will be paid by the individual; Within one year, the maximum amount of accumulated reimbursement for outpatient and emergency services of dispatched personnel is 20,000 yuan.

3. The insured shall properly keep the medical documents (including receipts and prescriptions for large amounts) in the outpatient department of the designated hospital. ), as a medical expense reimbursement certificate.

4. Outpatient treatment of three kinds of special diseases: when the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person is treated will issue the Certificate of Disease Diagnosis, fill in the Application and Approval Form for Special Diseases of Medical Insurance, and report it to the district medical insurance center for approval and filing.

Outpatient treatment and drug collection for these three special diseases are limited to designated hospitals that have approved treatment, and cannot be purchased in designated retail pharmacies. The medical expenses incurred meet the prescribed scope of outpatient special diseases, with reference to hospitalization settlement.

5. Hospitalization. After paying medical insurance for 20 years, you can enjoy medical insurance reimbursement after retirement.

Second, how much medical insurance do employees have to pay each year?

Generally speaking, in terms of employee medical insurance payment, men pay for 25 years and women pay for 20 years. In this case, you can also enjoy medical reimbursement after retirement. As for the payment standard, in fact, the annual payment amount is uncertain, depending on your salary base and payment grade. So, there is no definite quantity.

Employees' social security shall set up personal accounts, which are mainly used for seeking medical treatment in outpatient clinics of designated medical institutions and purchasing medicines in designated retail pharmacies. There is no personal account for residents' medical insurance, and outpatient medical treatment is coordinated. As the medical insurance certificate of the insured, there is no money in the medical insurance card, but the detailed information of the insured and the reimbursement of payment are recorded. It is recommended to consult the local social security bureau.

As for the amount returned, it is actually not fixed. Every employee's medical insurance payment standard is different, so the money returned is different. Also, generally speaking, only employees' medical insurance can refund their money, and individuals who pay medical insurance cannot refund their money. Because individuals pay social security at their own expense, there is no part paid by enterprises, so there is no refund before retirement, and only after retirement can the money be refunded to the card.

Three, the scope of medical insurance can not be reimbursed

1, did not see a doctor in a designated hospital.

Medical insurance cards can only be used in designated hospitals, and medical insurance will be reimbursed. Medical insurance will not be reimbursed for not seeing a doctor in a designated medical institution. Moreover, the higher the level of hospital treatment, the lower the reimbursement ratio.

2. Exceeding the reimbursement limit

After the unification of medical insurance for urban and rural residents, the real-time reimbursement of medical expenses has been realized, and the reimbursement ratio is still the same as before, but the accumulated reimbursement amount for one year is limited.

3. Special medical care

(1) Medical expenses for traffic accidents or work-related injuries due to personal reasons will not be reimbursed.

(2) Medical expenses caused by drunk driving, drug abuse, theft and other reasons will not be reimbursed by medical insurance.

(3) Medical expenses such as abortion and abortion caused by personal reasons will not be reimbursed by medical insurance.

(4) Medical expenses incurred due to plastic surgery, beauty, weight loss and other reasons will not be reimbursed by medical insurance.

4. Special treatment

Some medical projects will have special medical project funds, such as children's vaccines, and some related institutions will vaccinate children for free. If parents take their children for vaccination at their own expense, it is not within the scope of medical insurance reimbursement, and medical insurance will not be reimbursed.

Although the scope of medical insurance reimbursement is increasing now, there are still cases where medical insurance is not reimbursed. Therefore, everyone must understand the scope that medical insurance cannot be reimbursed, and avoid unnecessary troubles when reimbursing.

According to the law, we can know that the proportion of medical insurance reimbursement is related to many factors, and the reimbursement of different identities is also different, which is determined according to the actual situation.

Legal objectivity:

Article 28 of the 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.

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.