1. Outpatient medical reimbursement and proportion 1. The general outpatient medical insurance fund subsidizes the insured's outpatient medical expenses that exceed the threshold but meet the requirements within the maximum limit in a natural year. The specific standards are shown in the following table: 2. Subsidies for large outpatient medical expenses. In an insurance year, employees participating in basic medical insurance will be subsidized by the employee medical assistance fund according to the proportion of 5% of the ordinary outpatient medical expenses (except those covered by serious illness insurance) within the scope of medical insurance in designated medical institutions, and the part that the individual pays more than 6, yuan after being paid by the employee basic medical insurance fund according to regulations, with the maximum subsidy limit of 1, yuan. The enjoyment conditions and the scope of medical expenses of large medical expenses subsidies for employees' outpatient clinics are consistent with the general outpatient clinics of employees' basic medical insurance. 3. Outpatient chronic disease drug subsidy When the insured uses the drugs within the scope of the outpatient chronic disease drug subsidy catalogue in the designated units that meet the requirements, the expenses that meet the requirements of medical insurance can enjoy subsidies. Outpatient chronic disease drug subsidy amount is used on a monthly basis, and the balance amount of the current month can be transferred to the next month. The accumulated amount is valid in the current year and recalculated in the following year. 4, outpatient specific diagnosis and treatment project subsidies in designated medical institutions can directly enjoy the treatment of outpatient specific diagnosis and treatment projects, without going through other formalities. 5, outpatient specific disease subsidies outpatient treatment of the following diseases, in line with the provisions of the medical expenses can enjoy subsidies in accordance with the provisions. Among them, severe mental illness and hepatitis C can only enjoy subsidies when using drugs within a specified range in outpatient clinics. 6, outpatient serious illness subsidies within a year, in the selected designated medical institutions, the following serious illness outpatient treatment, in line with the provisions of the outpatient medical expenses can enjoy subsidies.
ii. scope and proportion of hospitalization reimbursement within a settlement year, the medical expenses incurred by the insured in hospital that meet the requirements will be paid by the medical insurance pooling (rescue) fund in proportion after exceeding the qifubiaozhun. Medical treatment in the city requires a social security card to swipe the card for medical treatment. Emotional mental disorders (mania, manic depression), the insured hospitalization medical expenses, in the original individual pays the proportion of the paragraph were reduced by half.
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