Icu is an intensive care unit, and the expenses incurred are reimbursed by medical insurance according to the actual project. Under normal circumstances, as long as the expenses are in the medical insurance reimbursement catalogue, they cannot be reimbursed if they are not in the medical insurance reimbursement catalogue, which is related to the local medical insurance policy and icu expense details.

However, the cost of icu is relatively high, and there is generally an upper limit for medical insurance reimbursement. If you want to reduce the pressure of icu expenses, it is best to supplement it with other commercial insurance.

Medical insurance is one of the basic social security policies in China, which provides basic protection for the health of China residents.

village

Outpatient service

Reimbursement for medical treatment in village clinics and village center clinics is 60%, and the prescription drug fee limit for each visit is 10 yuan, and the prescription drug fee limit for temporary rehydration for doctors in health centers is 50 yuan;

40% reimbursement for medical treatment in the town health center, the limit of each examination fee and operation fee is 50 yuan, and the limit of prescription drugs is 100 yuan;

Second-level hospitals will be reimbursed 30% for medical treatment, with each examination fee and operation fee limited to 50 yuan and prescription drug fee limited to 200 yuan;

Third-level hospitals will be reimbursed 20% for medical treatment. The examination fee and operation fee for each visit are limited to 50 yuan, and the prescription drug fee is limited to 200 yuan;

Chinese medicine invoice with prescription, each paste limit 1 yuan; The annual limit of outpatient compensation for town-level cooperative medical care is 5000 yuan [2].

be hospitalized

Reimbursement scope:

Medical expenses: auxiliary examination: the examination expenses of electrocardiogram, X-ray fluoroscopy, radiography, laboratory test, physiotherapy, acupuncture, CT and MRI are limited to 200 yuan;

Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan). The elderly over 60 years old are hospitalized in health centers, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.

Reimbursement ratio: town health centers reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.

serious illness

All inpatients who participate in cooperative medical care, whose medical expenses exceed 5,000 yuan at one time or for the whole year, should be compensated by stages, that is, 500 1- 10000 yuan is 65%, and1-18000 yuan is 70%.

The annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan.

exonerate

Medical treatment at one's own expense (no designated hospital or referral form), drugs purchased at one's own expense, drugs that cannot be reimbursed according to the provisions of public medical care, and medical expenses that do not conform to family planning; Outpatient treatment fee, visiting fee, hospitalization fee, meals fee, escort fee, nutrition fee, blood transfusion fee (except for family blood storage, which shall be reimbursed according to relevant regulations), cooling and heating fee, ambulance fee, special nursing fee, etc. Medical expenses for car accidents, fights, suicides, alcoholism, industrial accidents and medical accidents; Orthopedics, cosmetic surgery, dental implants, artificial limbs, organ transplantation, roll call surgery fees, consulting fees, etc. ; Within the scope of reimbursement, beyond the limit. [2]

cities and towns

Urban residents hospitalized for more than two times in a settlement year, starting from the second hospitalization, no longer charge Qifubiaozhun fees. Transfer or hospitalization for more than two times, make up the difference of Qifubiaozhun in accordance with the provisions of transfer or hospitalization again.

Students, children

In a settlement year, medical expenses less than 6,543,800 yuan+0.8 million yuan that meet the scope of reimbursement occurred. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

At least 70 years old and above.

In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

Other urban residents

In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold for tertiary hospitals is 659 yuan, the reimbursement rate is 50%, and the upper limit is 2,000 yuan. The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.