Medical insurance refers to the basic medical insurance premium paid in full and on time by employers and employees according to the principle of compulsory social insurance through national legislation. If it is not paid in full and on time, the basic medical insurance fund for its medical expenses will not be paid, regardless of personal accounts. Then, what is the reimbursement ratio of 20 17 for urban medical insurance?

What is the reimbursement rate of 20 17 urban medical insurance?

What is the reimbursement rate of 20 17 urban medical insurance? The reimbursement rate of urban medical insurance in 20 17 years is as follows: 1, which is reimbursed by general outpatient department. The annual payment limit for the second grade payment is 200 yuan, and the annual payment limit for the first grade payment is 80 yuan.

Proportion of reimbursement for urban medical insurance

2. Reimbursement for hospitalization in the city. The compliant medical expenses incurred within the scope of Qifubiaozhun to the maximum payment limit shall be paid according to the hospital level: 85% in the first-class hospital, 70% in the second-class hospital and 60% in the third-class hospital. First-level payment, 80% of first-level hospitals that implement essential drugs, and 60% of hospitals that do not implement essential drugs; Secondary hospitals pay 58%; The tertiary hospital pays 45%.

3, non insured medical reimbursement. Secondary payment, hospitalization in non-insured secondary and below designated medical institutions within the administrative area of Yantai City, without referral for approval, directly reimbursed in medical hospitals according to the prescribed proportion. The first-level payment can only be reimbursed in proportion in hospitals outside the city with the referral certificate issued by our city, and 10% of the medical expenses need to be paid in advance without referral approval.

4. reimbursement for medical treatment in different places. The second-level payment, with the referral certificate, goes to the designated hospital in the province for hospitalization, and is directly reimbursed in the hospital after discharge, enjoying the hospitalization reimbursement policy in Shandong Province. Individuals do not need to pay for hospitalization in advance. Down payment, after discharge, the individual pays the hospitalization expenses in full, and returns to the local hospital for reimbursement with the referral certificate.

5, outpatient chronic disease treatment reimbursement. Second-level payment, there is no capping line for chronic diseases in Class A outpatient service, and the reimbursement rate is 60%, which is 20% higher than the first-level payment; The reimbursement rate of chronic diseases in Class B outpatient department is 50%, which is higher than that in Class I 15%, and the capping line is about 50% higher than that in Class I. ..

Bian Xiao reminded that the following items cannot be reimbursed. Suicide, self-mutilation, fighting, drinking and taking drugs; Traffic accidents, medical accidents, work-related injuries and occupational diseases, plastic surgery, going abroad or going to Hong Kong, Macao and Taiwan for medical treatment. Medical treatment in designated medical institutions for non-urban residents' basic medical insurance without approval, and other illegal acts leading to illness, injury or disability.