How much reimbursement of RMB 380 per year by medical insurance depends on the specific medical insurance policy in your location.
The annual payment amount for medical insurance varies from region to region and is generally borne by both units and individuals. The unit payment ratio is approximately 8% and the individual payment ratio is 2%.
The reimbursement rate is usually around 70%, but it depends on the drug category and the level of medical service.
For example, Class A drugs may be reimbursed in full, Class B drugs may be reimbursed 80%, and Class C drugs may be reimbursed at your own expense.
In addition, there is a threshold for outpatient expenses, usually 1,800 yuan, and only the amount exceeding this amount can be reimbursed.
The starting point for reimbursement of chronic diseases in rural areas changes according to the number of diseases. For the part exceeding the starting point, the reimbursement ratio is 60%, with a maximum of no more than 3,000 yuan.
The reimbursement rate for special chronic diseases such as malignant tumors can reach 70%.
Therefore, the specific amount of reimbursement needs to be determined by referring to the local medical insurance policy and the individual’s actual medical expenses.
Reimbursement scope and proportion of medical insurance: 1. Reimbursement conditions: Medical insurance reimbursement usually requires treatment at designated medical institutions and comply with relevant regulations of medical insurance; 2. Reimbursement proportion: different regions and different types of medical insurance (such as urban employee medical insurance, urban and rural residents medical insurance
etc.) have different reimbursement ratios; 3. Deposit line: Some medical insurance policies have a deductible line, that is, medical expenses must exceed a certain amount before they can be reimbursed; 4. Cap line: The amount of medical insurance reimbursement usually has an annual cap limit.
The excess is the responsibility of the individual; 5. Drugs and items: Medical insurance reimbursement is usually only for drugs and treatment items in the medical insurance catalog; 6. Personal account: Under some medical insurance policies, funds in personal accounts can be used to pay a certain proportion of medical expenses.
To sum up, the amount of medical insurance reimbursement depends on the local medical insurance policy and the actual medical expenses of the individual, including factors such as payment amount, reimbursement ratio, drug category, and medical service level.
Therefore, it is impossible to determine how much medical insurance will reimburse 380 yuan a year, and it needs to be determined based on specific circumstances.
Legal basis: Article 28 of the "Social Insurance Law of the People's Republic of China" meets the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses, and shall be deducted from the basic medical insurance fund in accordance with national regulations.
Pay.