Wuhan medical insurance card cannot be used in Sanya.
(1) Reimbursement scope: hospitalization expenses incurred by insured persons in medical insurance designated hospitals or specialized hospitals, traditional Chinese medicine hospitals and Class A hospitals selected by individuals; (2) Reimbursement ratio: the minimum payment standard for the first hospitalization in a calendar year is 1,300 yuan.
650 yuan each time thereafter.
The payment ratio is divided into three levels. Taking a tertiary hospital as an example, the rising standard is: 30,000 yuan, 85% in employment, 91% in retirement, 90% in employment between 30,000 and 40,000 yuan, 94% in retirement, and 95% in employment above 40,000 yuan.
Retirement 97%.
A billing cycle is generally 90 days for hospitalization.
360 days for psychiatric hospitalization constitute a settlement cycle, and the fluctuation standard is halved.
The maximum overall fund payment within a calendar year is 70,000 yuan.
The maximum payment for large-amount hospitalization is 100,000 yuan, and the payment ratio for large-amount hospitalization is always 70%; (3) Medical treatment management: If the unit pays the fee in full, the individual only needs to pay part of the hospitalization prepayment to go through the hospitalization procedures.
The medical expenses incurred must comply with the scope of the three major catalogs of medical insurance; (4) Reimbursement process: When discharged, the hospital and the individual settle the self-pay and self-pay amounts, and the overall fund reimbursement amount is settled by the hospital and the district medical insurance center.