In p>224, the proportion of medical insurance reimbursement in Heilongjiang varies according to different policies and medical items. The main purpose is to reduce the burden of patients' medical expenses and ensure people's basic medical security.

I. Overview of the proportion of medical insurance reimbursement

In Heilongjiang Province, the proportion of medical insurance reimbursement is usually divided according to factors such as the type of medical expenses, the nature of treatment items and the identity of insured persons. Generally speaking, medical insurance can cover most basic medical expenses, including hospitalization expenses, operation expenses, drug expenses and so on. However, for some special projects or high-end medical services, the proportion of medical insurance reimbursement may be reduced or patients may have to bear part of the expenses themselves.

Second, the reimbursement ratio of different medical items

Hospitalization expenses: The reimbursement ratio of hospitalization expenses by medical insurance in Heilongjiang Province is usually high, but the specific ratio will be different according to the level of the hospital and the type of patients' participation. Generally speaking, the reimbursement rate of tertiary hospitals will be relatively low, while the reimbursement rate of primary medical institutions will be higher.

Drug expenses: Medical insurance reimbursement for drug expenses also varies according to the types and prices of drugs. Generally speaking, the reimbursement rate of commonly used drugs and essential drugs is high, while some imported drugs and high-end drugs may have a low reimbursement rate or require patients to pay their own expenses.

Special treatment items: For some special treatment items, such as organ transplantation and high-end examination, the reimbursement rate of medical insurance may be limited. These projects usually require patients to bear a high proportion of their own expenses.

Third, the influence of the identity of the insured on the reimbursement ratio

In Heilongjiang Province, the proportion of medical insurance reimbursement enjoyed by the insured with different identities will be different. Generally speaking, the reimbursement rate of urban workers' medical insurance is relatively high, while that of urban and rural residents' medical insurance is slightly lower. In addition, the government will also give certain medical assistance and subsidies to special groups such as the poor and the elderly.

To sum up:

In p>224, the reimbursement rate of medical insurance in Heilongjiang will be different according to different policies and medical items, and the reimbursement rate of different insured persons will be different. When enjoying medical insurance reimbursement, patients need to inquire and confirm according to their actual situation and types of medical expenses in order to better understand their medical security rights and interests. At the same time, the government is constantly improving the medical insurance policy, increasing the proportion of medical insurance reimbursement and reducing the burden of medical expenses for the people.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

stipulates:

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.

article 12 of the interim provisions on basic medical insurance for urban workers in Heilongjiang province stipulates:

the medical expenses paid by the basic medical insurance fund must conform to the provisions of the scope of basic medical insurance drugs, the scope of diagnosis and treatment items, the scope of medical service facilities and payment standards.

Article 14 of the Implementation Measures of Basic Medical Insurance for Urban and Rural Residents in Heilongjiang Province

stipulates:

The eligible hospitalization expenses incurred by insured residents in designated medical institutions shall be paid by individuals below the minimum threshold; The expenses above Qifubiaozhun and below the maximum payment limit shall be shared by the medical insurance fund and individual insured residents according to the prescribed proportion.