1. reimbursement rate of basic medical insurance outpatient service in Xiamen: for continuous insured personnel, the reimbursement rate of basic medical insurance will increase by one percentage point every full year, with a maximum increase of five percentage points. Where the insured registered in the city, every year in the implementation of the national basic drug system and zero price difference of community health service centers, township hospitals and other designated medical institutions below the municipal level outpatient medical treatment, belonging to the national basic drug medicine, medical treatment fees, routine medical examination fees, not more than 500 yuan part, by the medical insurance fund for full reimbursement.
2. Proportion of reimbursement for serious illness medical insurance in Xiamen: urban workers. Within the scope of medical insurance policy, the proportion of serious illness insurance payment is 75% for the part where the individual pays more than 1 10,000 yuan to 1 10,000 yuan; 65438+ 10,000 yuan to 200,000 yuan, and the proportion of serious illness insurance payment is 85%; From 200,000 yuan to the maximum compensation limit, the proportion of serious illness insurance payment is 95%. Urban and rural residents. Within the scope of the medical insurance policy, the proportion of out-of-pocket medical expenses for individuals whose deductible standard is more than 654.38+ 10,000 yuan is 60%; 65438+ 10,000 yuan to 200,000 yuan, the proportion of serious illness insurance payment is 70%; From 200,000 yuan to the maximum compensation limit, the proportion of serious illness insurance payment is 80%.
3. The reimbursement ratio of hospitalization medical expenses in Xiamen: Taking the medical insurance policy of employees in Xiamen as an example. If the total hospitalization medical expenses are 12000 yuan, of which the expenses within the scope of medical insurance policy are 1 1000 yuan, the threshold for the first hospitalization of tertiary hospital employees is 1000 yuan, and the reimbursement rate is 90%, then the medical insurance reimbursement amount is = (. If there is a balance in the personal account, you can deduct the personal payment.