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Dongtai medical insurance payment in 219

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can be reimbursed.

medical insurance reimbursement:

(1) reimbursement scope: hospitalization expenses incurred by insured persons in designated hospitals or specialized hospitals, Chinese medicine hospitals and Class A hospitals selected by individuals;

(2) reimbursement ratio: the minimum payment for the first hospitalization in a natural year is 1,3 yuan, and every time after that, 65 yuan. The payment ratio is divided into three grades. Take the tertiary hospital as an example. The fluctuation standard is: 3, yuan, 85% on the job, 91% on the job, 9% on the job from 3, to 4,, 94% on the job, 95% on the job and 97% on the job. 9 days of general hospitalization is a settlement cycle. Psychiatric hospitalization for 36 days is a settlement cycle, and the fluctuation standard is halved. In a natural year, the overall fund will pay up to 7, yuan. The maximum amount of hospitalization is 1, yuan, and the proportion of hospitalization is 7%;

(3) Management of medical treatment: If the unit pays the fee in full, the individual can go through the hospitalization formalities only by paying part of the advance payment for hospitalization. The medical expenses incurred should conform to the scope of the three major catalogues of medical insurance;

(4) reimbursement process: when discharged from hospital, the hospital and the individual will settle the self-funded and self-funded amount, and the reimbursement amount of the overall fund will be settled by the hospital and the district medical insurance center.