general hospitalization: when the insured person is hospitalized, he should pay the standard medical expenses first (tertiary hospital: 72 yuan; Secondary hospital: 48 yuan; Level I Hospital: 24 yuan; The Qifubiaozhun for multiple hospitalizations in one year is reduced to 1 yuan in turn, and the hospitalization standard for more than three hospitalizations is the same as that for the third hospitalization). Psychiatric patients are hospitalized in designated psychiatric medical institutions directly under the provincial government, and there is no deductible, and they do not participate in the decreasing calculation of deductible for hospitalization other than this category.
The medical expenses above the Qifubiaozhun and below the maximum payment limit of the overall fund shall be paid according to different levels of hospitals. For tertiary hospitals, the overall fund pays 88% and the individual pays 12%. Second-level hospitals: 91% from the overall fund and 9% from the individual; First-class hospital: 94% from the overall fund and 6% from the individual; The proportion of retirees' individual pays is reduced by three percentage points respectively. The medical expenses incurred by the insured in the treatment of mental illness in a psychiatric hospital are in line with the scope of payment by the medical insurance pooling fund, and the proportion of payment by the pooling fund is 95%.
if the reasonable medical expenses exceed the maximum payment limit of the basic medical insurance pooling fund, 9% of the eligible expenses shall be paid by the large medical expense subsidy fund, and 1% shall be paid by the individual.
those who enjoy the civil servants' medical subsidy: the insured persons use Class B drugs and pay part of the medical treatment items (excluding medical materials) during hospitalization, and the public subsidy funds will subsidize 8% for ordinary civil servants and 95% for medical care civil servants; In the deductible part of hospitalization, the public subsidy funds are 85% for general civil servants and 95% for medical care civil servants; For the part that should be borne by the individual below the maximum payment limit of the overall fund above the deductible line, the public subsidy funds will be 85% for general civil servants and 95% for medical care civil servants; Co-ordinate the fund's maximum payment limit above the large medical expenses subsidy fund's maximum payment limit below the individual pays part of the medical insurance, and the public subsidy fund subsidizes 9% of the general civil servants and 95% of the medical care personnel.