There are many diseases included in the scope of medical insurance reimbursement for urban residents, from colds and fever to cancer and serious illness, all of which are within the scope of insurance sales; According to the current backbone regulations, the following expenses incurred by the insured in designated medical institutions and retail pharmacies are included in the reimbursement scope of the basic medical insurance fund for urban residents.

1, hospitalization expenses

2. Medical expenses within 7 days before emergency observation and hospitalization.

3, in line with the provisions of the urban residents outpatient special disease medical expenses.

4. Other expenses that meet the requirements.

Extended data:

Proportion of reimbursement for basic medical insurance for urban residents

1, students, children

In a settlement year, medical expenses below RMB 6,543,800+0,800 yuan that meet the scope of reimbursement occurred. The threshold for tertiary hospitals is 500 yuan, and the reimbursement ratio is 55%; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

2. Older people over 70 years old.

In a settlement year, medical expenses below RMB 6,543,800+that meet the scope of reimbursement occur, and the threshold of tertiary hospitals is 500 yuan, and the reimbursement ratio is 50%; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

3. Other urban residents

In a settlement year, medical expenses below RMB 6,543,800+that meet the scope of reimbursement occur, and the threshold of tertiary hospitals is 500 yuan, and the reimbursement ratio is 50%; The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.

Urban residents hospitalized more than twice in a settlement year, starting from the second hospitalization, no longer charge Qifubiaozhun fee; Transfer or hospitalization for more than two times, make up the difference of Qifubiaozhun in accordance with the provisions of transfer or hospitalization again.

Baidu Encyclopedia-Basic Medical Insurance System for Urban Residents

Baidu encyclopedia-basic medical insurance for urban residents