Medical insurance is a policy formulated by the state to protect the rights and interests of employees. People who have paid medical insurance should know more about it. What are the scope of medical insurance reimbursement? The following is the latest medical insurance reimbursement of Hangzhou employees carefully compiled by Bian Xiao. I hope that the materials and procedures for reimbursement of medical insurance in Hangzhou will help you!

Regarding the reimbursement of medical insurance for Hangzhou 20 16, from the perspective of protecting the population, after the implementation of the new Measures, all the population including employees (retirees), urban and rural residents (college students, children and the elderly) will be covered, and the goal of medical insurance for all will be achieved. At present, there are more than 2,000 designated medical insurance institutions in Hangzhou. From tertiary medical institutions to community service centers, it is more convenient for insured people to seek medical treatment and purchase medicines.

20 16 what is the reimbursement rate of medical insurance in Hangzhou? What is the latest scope of reimbursement for medical insurance in Hangzhou? Hospitalization Qifubiaozhun above to 20000 yuan (inclusive), occurred in tertiary medical institutions, 76% before retirement; In secondary medical institutions, 80% before retirement; In other medical institutions, 84% before retirement; In community health service institutions, 86% before retirement. More than 20,000 yuan to 40,000 yuan (inclusive), occurred in tertiary medical institutions, 82% before retirement; In secondary medical institutions, 85% before retirement; In other medical institutions, 88% before retirement; In community health service institutions, 90% before retirement. More than 40,000 yuan to 6.5438+0.8 million yuan (inclusive), occurred in tertiary medical institutions, 88% before retirement; In secondary medical institutions, 90% before retirement; In other medical institutions and community health service institutions, it was 92% before retirement. More than RMB 6,543,800+0.8 million was borne by Medicaid funds for major diseases and individuals, of which the proportion of Medicaid funds for major diseases was: 88% for tertiary medical institutions; 90% of secondary medical institutions; Other medical institutions and community health service institutions 92%.

20 16 Hangzhou medical insurance reimbursement standard and new medical insurance reimbursement policy

Reimbursement ratio

Outpatient treatment:

In a settlement year, the general outpatient medical expenses incurred by the insured of basic medical insurance in line with the scope of medical insurance payment shall be paid by the individual account in that year. If the individual account is insufficient in that year, the individual shall bear the outpatient Qifubiaozhun 1 000 yuan. The proportion of medical expenses above the outpatient deductible line borne by individuals is: 24% of the expenses incurred by tertiary medical institutions; 20% of the expenses incurred in secondary medical institutions; The career in other medical institutions is16%; The commitment in community health service institutions is 14%.

Hospitalization:

1, undertake the one-time hospitalization Qifubiaozhun, specifically: tertiary and corresponding medical institutions (hereinafter referred to as tertiary medical institutions) are in 800 yuan, secondary and corresponding medical institutions (hereinafter referred to as secondary medical institutions) are in 600 yuan, and other medical institutions and community health service institutions are in 300 yuan.

2, the proportion of overall fund commitment is:

Hospitalization Qifubiaozhun above to 20000 yuan (inclusive), occurred in tertiary medical institutions, 76% before retirement; In secondary medical institutions, 80% before retirement; In other medical institutions, 84% before retirement; In community health service institutions, 86% before retirement.

More than 20,000 yuan to 40,000 yuan (inclusive), occurred in tertiary medical institutions, 82% before retirement; In secondary medical institutions, 85% before retirement; In other medical institutions, 88% before retirement; In community health service institutions, 90% before retirement.

More than 40,000 yuan to 6.5438+0.8 million yuan (inclusive), occurred in tertiary medical institutions, 88% before retirement; In secondary medical institutions, 90% before retirement; In other medical institutions and community health service institutions, it was 92% before retirement.

More than RMB 6,543,800+0.8 million was borne by Medicaid funds for major diseases and individuals, of which the proportion of Medicaid funds for major diseases was: 88% for tertiary medical institutions; 90% of secondary medical institutions; Other medical institutions and community health service institutions 92%.

Proportion of medical insurance reimbursement in Hangzhou

Tips: If you have any questions, you can also call the labor security consulting service hotline 12333 ext1-the municipal labor security consulting service hotline for manual service (Monday to Friday, 8: 45- 12: 00,13: 30-1.

Reimbursement scope

(a) the cost of western medicine, Chinese patent medicine and Chinese herbal pieces listed in the list of basic medical insurance drugs prescribed by the state and the province.

(two) included in the national and provincial provisions of the basic medical insurance treatment project costs.

(three) included in the national, provincial and municipal provisions of the basic medical insurance medical service facilities standards.

(four) according to the provisions of the designated medical institutions included in the scope of reimbursement of basic medical insurance self-made preparation costs.

(five) medical expenses that meet the scope of reimbursement of basic medical insurance due to emergency treatment in non-designated medical institutions in this Municipality or non-profit medical institutions outside this Municipality.