2, suffering from more than two kinds of chronic outpatient diseases, in accordance with the principle of "high is not low", to determine the annual payment limit, on this basis, the annual payment limit per person increased by 200 yuan.
3, outpatient chronic disease patients can not enjoy outpatient medical treatment at the same time during hospitalization, accounting for the highest payment limit of basic medical insurance, outpatient medical expenses and hospitalization medical expenses combined calculation.
4, outpatient special disease medical treatment according to the hospitalization standard, an insured year only calculate deductible, Qifubiaozhun according to the hospitalization level standard. Chronic disease subsidy targets: including insured persons in enterprises and institutions; Individual insured persons with flexible employment can enjoy subsidies for chronic diseases.
What is the reimbursement limit of medical insurance for employees in Hebei?
1. For general outpatient service, the deductible line for the insured to see a doctor in a designated medical institution is 400 yuan (payment with balance in the account, cash payment without balance in the account), whether on-the-job or retired. After that, the medical insurance fund will reimburse 2,000 yuan/year, and the self-payment ratio is: 20% for accounts with balance in personal accounts and 80% for medical insurance as a whole; If there is no balance in the personal account, 30% will be paid, and 70% will be paid by medical insurance as a whole.
2. The reimbursement limit of 38 kinds of chronic diseases remains unchanged, and the reimbursement ratio: 10% for accounts with balance in personal accounts, and 90% for medical insurance as a whole; If there is no balance in the personal account, 20% will be paid and 80% will be paid by the medical insurance as a whole.
3, seven people, no deductible, when the personal account has a balance, the account pays 10%, the medical insurance pays 90%, and when the personal account has no balance, the individual pays 4%. Patients suffering from chronic diseases in intensive care clinics do not need to apply for chronic diseases. Overall payment of more than 30 thousand yuan, individuals can apply to the provincial medical insurance for the record at any time, personal burden of 4%.
legal ground
People's Republic of China (PRC) social insurance law
Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.