Tongliao Medical Insurance Reimbursement Ratio, Policy, Conditions, Scope, and Payment Standards in 2021-2022 Tongliao Medical Insurance Reimbursement Scope 1. The applicant has completed the insurance enrollment procedures and paid the medical insurance premium in full. 2. Seek medical treatment at designated medical institutions of the cooperative medical system. 3. If the insured person incurs hospitalization medical expenses while seeking treatment at a registered medical institution, he must pay cash in advance and keep relevant documents and information.

The reimbursement ratio of Tongliao Medical Insurance 1. Only medical expenses of more than 1,800 yuan can be reimbursed after going to the hospital's outpatient department or emergency department, and the reimbursement ratio is 50%; 2. If you are retired under the age of 70 For employees, expenses above 1,300 yuan can be reimbursed, and the reimbursement rate is 70%; 3. For retirees over 70 years old, expenses above 1,300 yuan can be reimbursed at 80%. Note: Regardless of the type of person, the maximum amount of large-amount medical expenses paid for outpatient and emergency services is 20,000 yuan. If it is hospitalization expenses, when the basic medical insurance is used for payment for the first time in a year, the minimum payment amount is 1,300 yuan for both working people and retirees. For medical expenses for the second and subsequent hospitalizations, the minimum payment standard is determined at 50%, which is 650 yuan. The maximum payment amount of the basic medical insurance pooling fund (hospitalization expenses) in one year is currently 70,000 yuan. The standard of hospitalization reimbursement is related to the level of the hospital where the insured person lives: Note: If the insured person lives in a third-level hospital. 1. For expenses from the minimum payment standard to 30,000 yuan, employees pay 15%, which is 85% reimbursement; 2. For expenses from 30,000 yuan to 40,000 yuan, employees pay 10% and 90% is reimbursed; 3. For expenses exceeding 40,000 yuan, 95% of the expenses up to the maximum payment limit can be reimbursed, and employees only need to pay 5%; 4. The proportion of individual payment by retirees is 60% of that of active employees.

Tongliao Medical Insurance Payment Standard The Tongliao Municipal Medical Insurance Administration Bureau was informed that the payment standard for the basic medical insurance for urban and rural residents in our city has been determined and will be adjusted to 260 yuan for all insured persons.