I. Problems

What is the reimbursement standard of Linyi medical insurance and how to calculate the reimbursement amount?

Second, answer

The reimbursement standard of Linyi medical insurance is based on different medical expenses and reimbursement items. Generally speaking, medical insurance reimbursement includes outpatient reimbursement, hospitalization reimbursement, chronic disease reimbursement and special disease reimbursement. For specific reimbursement standards, please refer to local medical insurance policies or consult local medical insurance departments.

When calculating the reimbursement amount, you need to know the deductible line and the capping line of medical insurance first. The deductible line refers to the minimum standard for the medical insurance fund to start paying medical expenses, and the capping line refers to the maximum limit for the medical insurance fund to pay medical expenses. The part below the deductible line needs to be borne by yourself, and the part above the capping line needs to be borne by yourself.

Third, to sum up.

The reimbursement standard of Linyi medical insurance depends on different medical expenses and reimbursement items. For specific standards, please refer to the local medical insurance policy or consult the local medical insurance department. When calculating the reimbursement amount, you need to know the deductible line and the capping line of medical insurance and calculate according to the actual situation.

Fourth, the legal basis

Article 28 of the Social Insurance Law of People's Republic of China (PRC) stipulates that medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29 of the Social Insurance Law of People's Republic of China (PRC) stipulates that the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.