There is no deductible line for general outpatient service, and all insured residents enjoy the treatment of general outpatient service. Within a medical insurance year, there is no deductible line for general outpatient service, and the medical expenses within the scope of outpatient co-ordination fund payment are reimbursed according to the proportion of 60%, and the annual maximum personal payment limit of co-ordination fund is 400 yuan.
2. Proportion of hospitalization reimbursement
The longer the continuous insurance period, the greater the reimbursement ratio. The proportion of hospitalization reimbursement of medical insurance fund will be increased by 5 percentage points every 5 years after the insured residents pay continuously, and the cumulative reimbursement ratio will not exceed 10 percentage point. If you continue to participate in insurance 10 years from 2007, the reimbursement rates of hospitalization in tertiary, secondary and primary hospitals will reach 70%, 80% and 90% respectively.
3. Secondary reimbursement ratio
After the "second reimbursement", the medical expenses incurred by the insured residents in a single hospitalization belong to the part paid by the urban residents' basic medical insurance pooling fund, and there may be a "second reimbursement". After the basic medical insurance fund is paid in proportion, the personal burden exceeds 8,000 yuan, and the serious illness insurance fund gives "second reimbursement" to more than 55%.
For the medical expenses incurred by the insured residents in hospitalization for many times within one year, after the basic medical insurance and the "second reimbursement" payment, if the annual accumulated hospitalization medical expenses of the insured residents (including the compliant and reasonable self-funded part) exceed 1 10,000 yuan, the excess part will be reimbursed by the serious illness insurance fund according to the proportion of 55%. The maximum annual payment limit of the serious illness insurance fund is 250,000 yuan.
4. Reimbursement amount
The maximum annual reimbursement is 370,000 yuan for residents who participate in medical insurance for urban residents in our city. The annual payment limit for basic medical insurance is 6,543,800 yuan+0.2 million yuan, and the annual payment limit for serious illness insurance is 250,000 yuan. Therefore, the insured can reimburse up to 370,000 yuan per year.
20 17 payment of medical insurance for urban residents
From August 20 17 to August 2065438 1 October 30 +0 165438, the overdue payment system was closed and payment was no longer accepted.
1. Ordinary urban residents, primary and junior high school students and children are insured for the first time: please bring the original and copy of the household registration book (or resident ID card) to the community where the household registration is located (or where the family lives) for registration;
2.5 working days later, please bring your residence booklet or resident ID card to the nearest bank outlet to pay the fee; From the day after payment, please bring the payment voucher and the cost of 7 yuan medical insurance card to the district social security center where the household registration is located (or where the family lives) to apply for the medical insurance card.
3. Insured renewal: Please bring your ID card or medical insurance card and pay directly at the nearest bank outlet.