The proportion of residents' medical insurance reimbursement varies with different groups of people and different hospital levels. Where: 1. Students and children (less than 6.5438+0.8 million yuan): the reimbursement rate of tertiary hospitals is 55%; The reimbursement rate of secondary hospitals is 60%; The reimbursement rate of first-class hospitals is 65%. Second, the elderly over 70 years old (below 654.38+ 10,000 yuan): the reimbursement rate of tertiary hospitals is 50%; The reimbursement rate of secondary hospitals is 60%; The reimbursement rate of first-class hospitals is 65%. Third, other urban residents (less than 6.5438+10,000 yuan): the reimbursement rate of tertiary hospitals is 50%; The reimbursement rate of secondary hospitals is 55%; The reimbursement rate of first-class hospitals is 60%.

legal ground

1. Notice on the payment scope and standard of outpatient dialysis treatment of Guangzhou basic medical insurance pooling fund. Insured persons (hereinafter referred to as insured patients) who are diagnosed and confirmed to have uremia by designated medical institutions designated by the administrative department of medical insurance in this Municipality and need long-term outpatient peritoneal dialysis and hemodialysis treatment can enjoy medical insurance benefits for uremia outpatient dialysis treatment for specific projects according to regulations. The list of designated medical institutions shall be announced separately by the municipal medical insurance agency. Second, the insured patients should choose a designated medical institution (hereinafter referred to as the selected hospital) in the designated medical institution 1. Once selected, in principle, it cannot be changed within 1 year. Insured patients really need to change the selected hospital due to illness, migration of residence and other reasons, and can go through the change procedures in the medical insurance agency. Three, designated medical institutions to provide outpatient dialysis treatment for insured patients to implement the management of medical insurance responsible doctors, and unified use of social medical insurance outpatient special project medical records. Specific measures by the medical insurance agencies and designated medical institutions signed a service agreement. Four, the insured uremia outpatient dialysis treatment of basic medical expenses, basic medical insurance fund payment ratio, respectively, according to the relevant provisions of the city's basic medical insurance for urban workers, basic medical insurance for urban residents and basic medical insurance for urban flexible employees.

legal ground

Notice on the scope and standard of Guangzhou basic medical insurance co-ordination fund to pay dialysis treatment expenses for uremia outpatients stipulates: 1. After the diagnosis and confirmation of the designated medical institutions designated by the medical insurance administrative department of this Municipality, the insured persons who need long-term outpatient peritoneal dialysis and hemodialysis treatment (hereinafter referred to as the insured patients) can enjoy the medical insurance benefits of uremia outpatient dialysis treatment for specific projects in accordance with the regulations.

The list of designated medical institutions shall be announced separately by the municipal medical insurance agency.

Second, the insured patients should choose a designated medical institution (hereinafter referred to as the selected hospital) in the designated medical institution 1. Once selected, in principle, it cannot be changed within 1 year. Insured patients really need to change the selected hospital due to illness, migration of residence and other reasons, and can go through the change procedures in the medical insurance agency.

Three, designated medical institutions to provide outpatient dialysis treatment for insured patients to implement the management of medical insurance responsible doctors, and unified use of social medical insurance outpatient special project medical records. Specific measures by the medical insurance agencies and designated medical institutions signed a service agreement.

Four, the insured uremia outpatient dialysis treatment of basic medical expenses, basic medical insurance fund payment ratio, respectively, according to the relevant provisions of the city's basic medical insurance for urban workers, basic medical insurance for urban residents and basic medical insurance for urban flexible employees.