Must be to participate in urban and rural residents' medical insurance, or rural new rural cooperative medical insurance, and buy separately.
If the annual expenses exceed the specified number, you can enjoy the second reimbursement. When making the second reimbursement, you need to bring your own medical record, the first reimbursement certificate and the discharge certificate.
The second reimbursement refers to the reimbursement of serious illness, and the expenses in different places are not reimbursed. The floating amount depends on individual local social security regulations. In the past, Shandong was reimbursed for more than 30,000 yuan, but now it is reduced to12,000 yuan, but it must be a disease within the scope of social security regulations, and not all diseases are reimbursed. The minimum payment is 50% or more.
First of all, critical illness insurance is not reimbursed according to the disease, but according to the total cost of medical treatment for this person within one year. If the expenses exceed a certain amount, no matter what disease the insured suffers from, they can be reimbursed according to the corresponding proportion. Residents who participate in urban residents' medical insurance can be reimbursed if the remaining personal out-of-pocket expenses within the scope of medical insurance reimbursement exceed the annual per capita disposable income of urban residents in the city last year (hereinafter referred to as deductible). If the excess is less than 50 thousand, it will be reimbursed by the serious illness insurance fund 50%; Expenses exceeding 50,000 yuan shall be reimbursed by the serious illness insurance fund by 60%.
legal ground
The Decision of the State Council on Establishing the Basic Medical Insurance System for Urban Workers stipulates the reimbursement ratio of medical insurance.
Pediatric hospitalization, Qifubiaozhun reduced by 50% on the basis of the above standards; Insured residents in a natural year for the second time and above hospitalization, Qifubiaozhun according to 50% of the above standards; After deductible and self-funded expenses are deducted from the hospitalization medical expenses of insured residents, if the actual reimbursement ratio is less than 50%, it will be reimbursed by 50%; The reimbursement rate of insured residents for continuous payment will be increased by 5% every 3 years, and the cumulative amount will not exceed 10%.
For Class B drugs and special examinations used by the insured during hospitalization, the individual shall pay 5% and 20% respectively and then reimburse them according to the relevant proportion. The hospitalization bed fee of the insured is included in the scope of reimbursement according to the maximum 30 yuan/day, and reimbursed according to the relevant proportion; Less than 30 yuan/day shall be reimbursed according to actual expenses. The maximum reimbursement in a natural year is 6.5438+0.6 million yuan.