medical insurance refers to social medical insurance, which is a social insurance system established to provide basic medical needs protection for workers within the scope of protection. The basic medical insurance premiums paid by individual employees are all included in individual accounts; The basic medical insurance premium paid by the employer is divided into two parts, one part is included in the personal account and the other part is used to establish the overall fund. In this paper, I ask you to introduce the related knowledge about Shantou medical insurance reimbursement. Mainly includes Shantou medical insurance reimbursement process, Shantou medical insurance reimbursement ratio, Shantou medical insurance reimbursement policy related information.

1. Shantou medical insurance reimbursement process and required materials reimbursement scope 1. The insured person goes to a designated medical institution in this city for medical treatment; 2. The insured person needs to seek medical treatment in a non-designated medical institution in this Municipality for emergency rescue; 3. Due to the conditions of the designated medical institutions in this Municipality, the insured person must go to a non-designated medical institution in this Municipality for medical treatment; 4, because the insured person settled in a different place or lived in a different place, he went to the medical institution in his place of residence for medical treatment.

Handling conditions 1. Urban and rural residents with local household registration who are not covered by the basic medical insurance for employees; 2, in the administrative area of this Municipality, all kinds of institutions of higher learning, scientific research institutions, secondary vocational and technical schools and technical schools are full-time students who are not registered in this Municipality; 3. All kinds of enterprises, state organs, institutions, social organizations, private non-enterprise units (hereinafter referred to as employers) and their employees (including retirees) within the administrative area of this Municipality.

reimbursement process hospitalization reimbursement process: 1. The basic medical expenses incurred by the insured in the designated medical institutions shall be settled by the designated medical institutions and individuals if they are paid by individuals; 2, belonging to the medical insurance fund payment, by the designated medical institutions in accordance with the provisions of accounting, and then settlement with social insurance agencies. Note: Under special circumstances, if the basic medical expenses cannot be accounted for, the insured person will pay in advance and then go through the reimbursement procedures at the social insurance agency. Hospitalization reimbursement process: if the insured person is hospitalized in a designated medical institution, and is eligible to enjoy basic medical assistance in urban and rural areas, medical assistance for key entitled groups or rehabilitation medical assistance for the disabled after examination by the civil affairs and the Disabled Persons' Federation, the medical assistance (subsidy) fee can be settled immediately at the designated medical institution when he is discharged.

ii. Shantou medical insurance reimbursement ratio and related policy reimbursement ratio hospitalization reimbursement expenses: the minimum payment standards for the insured to be hospitalized in designated medical institutions in this city are: 2 yuan, a first-level medical institution, 4 yuan, a second-level medical institution, and 1 yuan, a third-level medical institution. Qifubiaozhun for the insured to be hospitalized in non-designated medical institutions in this city is 1 yuan. When the insured person is hospitalized, the Qifubiaozhun will be reduced or exempted with reference to the relevant provisions of the basic medical insurance for employees in this Municipality. The basic medical expenses above the Qifubiaozhun shall be paid by the medical insurance fund according to the following proportions: 9% for the first-class designated medical institutions above the deductible line in 2 yuan, 8% for the second-class designated medical institutions above the deductible line in 4 yuan, 63% for the third-class designated medical institutions above the deductible line in 1 yuan and 48% for the non-designated medical institutions above the deductible line in 1 yuan. Outpatient medical expenses: Qifubiaozhun: no reimbursement ratio: 5% paid by the medical insurance fund. The annual limit for the insured to enjoy the overall treatment of general outpatient service is: 12 yuan per person per year. Tips: The general outpatient co-ordinate basic medical expenses limit is used in the current year and will not be carried forward. The limit of basic medical expenses for general outpatient service among family members can be combined. If the insured person is insured in the middle of the year, he does not enjoy the overall treatment of general outpatient service. Outpatient-specific diseases: the insured enjoys the treatment of specific diseases in the pilot outpatient service: the part above the Qifubiaozhun and within the reporting limit of monthly basic medical insurance expenses shall be paid by the overall fund at a rate of 75%. The insured person enjoys the treatment of other outpatient specific diseases as follows: the part above Qifubiaozhun and within the limit of annual basic medical expenses shall be paid by the overall fund according to the proportion of 5%. If the insured person meets the requirements to set up a family sickbed, the basic medical expenses that meet the requirements shall be above the Qifubiaozhun in 4 yuan, and the proportion of overall fund payment shall be 5%. Note: If the insured person can enjoy the treatment of outpatient specific diseases for less than one year, the Qifubiaozhun and the limit of basic medical expenses for outpatient specific diseases shall be calculated in proportion. If the insured suffers from two or more outpatient diseases at the same time, the limit of basic medical expenses for outpatient diseases shall be approved according to the highest one.