Hospitalization means that only hospitalization expenses can be reimbursed, and outpatient expenses cannot be reimbursed. Hospitalization expenses must be paid in advance, that is, all the money within the self-payment period must be paid at your own expense. Self-payment criteria: determined according to different levels of medical institutions:

① First hospitalization, first-level medical institution 5 yuan, second-level medical institution 6 yuan, third-level medical institution 7 yuan,

② Second hospitalization, first-level medical institution 4 yuan, second-level medical institution 5 yuan and third-level medical institution 6 yuan.

③ No Qifubiaozhun will be set for the third hospitalization (including the third hospitalization) and every subsequent hospitalization in a settlement year. The money that exceeds the self-payment period will be accounted for and reimbursed. ?

The basic hospitalization expenses refer to the ordinary bed fees, examination fees, medical insurance drug fees, and the medical expenses that are above the qifubiaozhun of the overall fund and below the maximum payment limit are paid by the overall fund according to the following proportions, and employees and retirees also have to bear a certain proportion of expenses:

88% (9.4% of retirees) are paid by the overall fund of the first-level medical institutions, and 12% (9.6% of retirees) are paid by individuals.

Secondary medical institutions pay 85% (88% of retirees) from the overall fund, and individuals pay 15% (12% of retirees);

82% (85.6% for retirees) is paid by the funds of tertiary medical institutions, and 18% (14.4% for retirees) is paid by individuals.

Extended information:

Hospitalization expense reimbursement information:

Medical insurance reimbursement

1. Original and photocopy of the insured person's ID card (if entrusted by others, the original and photocopy of the entrusted person's ID card must be provided at the same time);

2. The original and photocopy of the insured's medical insurance card. If there is no medical insurance card, the insured shall provide the original and photocopy of his bank passbook (card);

3. Original and photocopy of the charge receipt;

4. Detailed list of hospitalization expenses (note: it is not a daily expense list);

5. Discharge summary or discharge record. If the discharge summary is handwritten in the medical record, copy the discharge summary and the cover of the medical record;

6. certificate of disease diagnosis (death certificate is required in case of death);

7. Minors should provide household registration book (photocopy) and guardian ID card at the same time. In case of giving birth or terminating pregnancy, they should also provide relevant certificates from the family planning department (original and photocopy of marriage certificate and birth permit), rural five-guarantee households should provide valid certificates issued by the civil affairs department, and drivers' licenses and photocopies should be provided for traffic accidents.

Baidu encyclopedia-hospitalization expenses