In the basic medical insurance, the outpatient expenses of the insured are included in the reimbursement scope of the overall fund.
The basic medical insurance premium is paid by both the employer and the employee. The employer's contribution rate should be controlled at about 9% of the total wages of employees, and the employee's contribution rate is generally 2% of his salary income. With the development of economy, the contribution rates of employers and employees can be adjusted accordingly. The basic medical insurance fund consists of overall funds and individual accounts. The basic medical insurance premiums paid by individual employees are all included in individual accounts. The basic medical insurance premium paid by the employer is divided into two parts, one part is used to establish the overall fund, and the other part is included in the personal account. Medical expenses below Qifubiaozhun shall be paid by personal account or borne by individuals. Medical expenses above Qifubiaozhun and below the maximum payment limit are mainly paid from the overall fund, and individuals also have to bear a certain proportion. Medical expenses exceeding the maximum payment limit can be solved by means of commercial medical insurance.
Outpatient co-ordination is a form of medical insurance benefits. Simply put, the general outpatient expenses of the insured person are included in the scope of reimbursement, and the outpatient expenses are shared by the basic medical insurance fund and individuals. The implementation of outpatient co-ordination has enhanced the support ability of medical insurance fund, which not only facilitates the people to seek medical treatment, but also reduces the cost of medical services, reduces the burden of outpatient expenses of insured personnel and improves the efficiency of medical insurance fund. At the same time, it improves the fairness of medical insurance, which is conducive to improving the attractiveness of medical insurance and encouraging everyone to actively participate in insurance.
Insured residents need to bring their social security card (or medical insurance certificate) and other valid documents to swipe their cards for medical treatment when purchasing medicines in designated primary medical institutions within their jurisdiction, and they can choose whether to set the place as a designated medical institution for outpatient co-ordination. After confirmation, the medical institution will register the residents for the record. After the record is successful, the medical institution can use the outpatient co-ordination fund for reimbursement. In principle, the designated medical institutions for residents' outpatient co-ordination must be one year, and the designated medical institutions for outpatient co-ordination can be re-determined the following year.