Scope of use of medical insurance card

First, outpatient and emergency expenses.

1. The medical expenses above 1800 yuan can only be reimbursed after the on-the-job employees see a doctor in the emergency department of the hospital, and the reimbursement rate is 50%.

2. Retirees under the age of 70,1.Expenses above 300 yuan can be reimbursed, and the reimbursement rate is 70%.

3. Retirees over 70 years old,1.Expenses above 300 yuan can be reimbursed by 80%.

Second, the hospitalization expenses.

The maximum annual payment limit (hospitalization expenses) of the basic medical insurance pooling fund is currently 70,000 yuan.

1, the standard of hospitalization reimbursement is related to the level of the hospital where the insured person is located. If you live in a tertiary hospital, the employee pays 15%, which is 85% of the reimbursement, from the minimum threshold to 30,000 yuan.

2, 30,000 yuan to 40,000 yuan, the employee's individual contribution 10%, 90% reimbursement;

3, more than 40000 yuan to the maximum payment limit, 95% can be reimbursed, employees only need to pay 5%.

4. The individual contribution ratio of retirees is 60% of the on-the-job (i.e. the above) employees, but all below the threshold is paid by individuals.

Three, designated hospitals and retail pharmacies

Reimbursement scope of designated hospitals and retail pharmacies: The insured can only be reimbursed if he visits four designated medical institutions (except emergency) or designated Chinese medicine and specialties (including stomatological hospitals, maternity hospitals, cancer hospitals, etc.). ) and 1 1 Class A medical institutions.