Compared with basic medical insurance, supplementary medical insurance includes enterprise supplementary medical insurance, commercial medical insurance, social mutual assistance and community medical insurance, which is a powerful supplement to basic medical insurance and an important part of multi-level medical security system.
Different from basic medical insurance, supplementary medical insurance is not enforced by national legislation, but is voluntarily participated by employers and individuals. It is a kind of supplementary insurance that the unit or individual appropriately increases the medical insurance items according to the needs and possible principles after the units and employees participate in the unified basic medical insurance, so as to improve the insurance protection level.
Basic medical insurance and supplementary medical insurance are not contradictory, but complementary and irreplaceable, and their purpose is to provide medical security for employees.
Supplementary medical insurance reimbursement:
The minimum qifubiaozhun is 250 yuan.
Qifubiaozhun is: 250 yuan, a community health service institution; 350 yuan, a first-class hospital; 500 yuan, a secondary hospital; 700 yuan, a tertiary hospital.
In accordance with the provisions of Qifubiaozhun above and below the maximum payment limit of hospitalization medical expenses, in different levels of designated medical institutions to pay different proportions:
1, urban non-employed residents
Community health service institutions: 70% paid by the overall fund and 30% borne by individuals; First-class hospitals: 60% of overall funds and 40% of individuals; Secondary hospitals: 50% paid by the overall fund and 50% borne by individuals; Third-level hospitals: 40% is paid by the overall fund, and 60% is borne by individuals.
2, children's overall fund payment ratio according to the corresponding standard of urban non employed residents increased by 5%.
Second-class outpatient serious illness expenses can be reimbursed.
Serious outpatient diseases include: special outpatient diseases (radiotherapy and chemotherapy for malignant tumors, outpatient renal dialysis, taking anti-rejection drugs after organ transplantation) and chronic diseases (hypertension, coronary heart disease, diabetes).
Outpatient treatment of special diseases: 50% from the overall fund and 50% from individuals; Outpatient treatment of chronic diseases: In one year, if the medical expenses for outpatient treatment of chronic diseases in designated medical institutions exceed 350 yuan, the excess will be paid by the overall fund according to the standard of 50%, and the maximum payment limit of the overall fund is 2,000 yuan.
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