Inner Mongolia medical insurance outpatient reimbursement is 2%. The details are as follows: 1. When the Inner Mongolia employee medical insurance participants enjoy the general outpatient co-ordination treatment, the co-ordination fund will pay in proportion. The payment proportion of third-level medical institutions is 60%, and the payment rate of second-level and below medical institutions is
is 80%, with an increase of 5 percentage points for retirees; 2. All basic medical insurance premiums paid by insured units will be included in the overall fund.
In the personal accounts of active employees, basic medical insurance premiums paid according to 2% of the insured payment base are included; 3. The personal accounts of retirees are gradually adjusted to be transferred from the overall fund according to a fixed amount; 4. The deductible standard for hospitalization is clarified: Adjust hospitalization
The reimbursement ratio adjusts the reimbursement ratio for out-of-town hospitalization.
Policies and reimbursement ratios vary from place to place. The specific reimbursement policies of each place shall prevail. The outpatient reimbursement ratio of employee medical insurance is roughly as follows: Urban employee medical insurance: Active employees: The outpatient exemption limit is 2,000 yuan, which is included in the medical expenses incurred in outpatient services.
, only the part exceeding 2,000 yuan will be reimbursed, and the reimbursement ratio is 50%; 5. Retired employees: The outpatient exemption limit is 1,300 yuan, that is, only the part of the medical expenses incurred in the outpatient service exceeding 1,300 yuan will be reimbursed, 70
For those under the age of 70, the reimbursement rate is 70%, while for those over 70 years old, the reimbursement rate is 80%.
Scope of medical insurance reimbursement: 1. Insurance liability for hospitalization medical expenses within the scope of medical insurance. The part of the expenses in the medical insurance catalog that is still borne by the individual after being reimbursed by basic medical insurance, critical illness insurance, medical assistance, etc. shall bear the payment responsibility within the agreed scope of insurance liability.
1 million insured amount, 15,000 yuan deductible, reimbursement ratio 80%, continuous insurance reimbursement ratio increased to 85%; 2. Insurance liability for hospitalization medical expenses outside the scope of medical insurance, after reimbursement through basic medical insurance, critical illness insurance, medical assistance, etc.
For the expenses outside the medical insurance catalog that are still borne by the individual, the payment responsibility will be within the agreed scope of insurance liability.
The insured amount is 1 million yuan, the deductible is 18,000 yuan, the reimbursement rate is 60%, and the reimbursement rate for continuous insurance is increased to 65%; in summary, in general, the reimbursement rate is 2%.
After adjusting the overall pooling fund and individual account structures, the increased pooling fund is mainly used for outpatient services to improve the outpatient benefits of insured persons.
Legal basis: Article 2 of the "Insurance Law of the People's Republic of China". The term "insurance" as mentioned in this law refers to the policy holder paying the insurance premium to the insurer in accordance with the contract, and the insurer's liability for the possible accidents stipulated in the contract due to the occurrence of the accident.
It is a commercial insurance act that bears the liability for insurance compensation for the property losses caused, or assumes the liability for insurance benefits when the insured dies, becomes disabled, becomes ill, or reaches the age, term and other conditions specified in the contract.
Article 3 This Law shall apply when engaging in insurance activities within the territory of the People's Republic of China.
Article 5 The parties involved in insurance activities shall abide by the principle of good faith when exercising their rights and performing their obligations.