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Yiwu medical insurance reimbursement policy

Legal analysis: The "New Deal" of medical insurance stipulates that the basic medical insurance financing standard will be adjusted as follows: the individual financing standard of basic medical insurance for urban and rural residents (including serious illness medical insurance and chronic disease outpatient co-ordination) is 8 yuan per person per year for large amount, 2 yuan per person per year for small amount, and the financial subsidy standard is 6 yuan per person per year (including health check-up fee) for Yiwu municipal financial subsidy, and 1 yuan per person per year for town (street) financial subsidy.

legal basis: social insurance law of the people's Republic of China article 2 the state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance, etc., to protect citizens' right to get material help from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity. Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations. Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.

article 29 of the measures for the implementation of basic medical insurance in yiwu city (ii) the scope, payment ratio and maximum payment limit of compliant medical expenses 1. the basic medical insurance pays the over-limit part, the self-paid part of special medical treatment items, the self-paid part of reimbursement ratio, the self-paid part of drugs in the catalogue (except for the self-paid part exceeding 3%) and the standard hospitalization deductible fee, and the small insured persons, large insured persons and employees of the basic medical insurance of urban and rural residents. 2. During hospitalization, the out-of-catalog drug expenses, the expenses of restricted drugs and medical materials that are not paid as a whole, and the expenses of non-imported medical materials that exceed the limit are paid at a rate of 5%. The reimbursement model and proportion of outpatient expenses for special diseases of malignant tumors refer to supplementary medical insurance for employees. 3. The maximum payment limits for small, large and basic medical insurance for urban and rural residents are 18,, 32, and 38, respectively.