1. Compensation for medical expenses borne by individuals within the scope of medical insurance catalogue: medical expenses within the scope of medical insurance catalogue for hospitalization of chronic diseases (including two parts: individual pays and individual pays).
2. Compensation for personal expenses outside the scope of medical insurance catalogue: medical expenses incurred by individuals outside the scope of medical insurance catalogue at their own expense. "
What can Ping An Buddha medical insurance reimburse?
1. Personal medical expenses compensation within the scope of medical insurance catalogue: the minimum payment is 20,000 yuan, the reimbursement ratio is 80%, and the annual compensation limit is 1 10,000.
2. Compensation for personal expenses outside the scope of medical insurance: the minimum payment is 25,000 yuan, the reimbursement ratio is 60%, and the annual limit is 654.38+00,000 yuan.
3. Out-of-pocket drug compensation for specific tumor diseases in basic medical insurance outpatient department: the minimum payment standard is 1 10,000-10.5 million. If the insured has suffered from malignant tumor before the first insurance, the reimbursement rate is 60%. Payout ratio is 90% of those diagnosed as malignant tumor for the first time after insurance, and the annual limit is126,000 yuan.
4. Compensation for ultra-high medical expenses within the scope of medical insurance catalogue: the minimum payment is 200,000 yuan, the reimbursement ratio is 90%, and the annual compensation limit is 270,000 yuan.
5, COVID-19 safety responsibility. COVID-19's critical/critical diagnosis insurance premium is 20,000 yuan, and COVID-19's death insurance premium is 654.38+10,000 yuan.
legal ground
People's Republic of China (PRC) social insurance law
Article 73 Social insurance agencies shall establish and improve business, financial, safety and risk management systems. Social insurance agencies shall pay social insurance benefits in full and on time. ;
Article 8 of the Social Insurance Law of People's Republic of China (PRC) provides social insurance services and is responsible for social insurance registration, personal rights and interests record and social insurance benefits payment.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
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