Since February 1 2023, Wuhan has officially implemented the overall medical insurance for employees, and the general outpatient expenses can be reimbursed if they meet the requirements.
The reimbursement ratio of medical insurance outpatient service for Wuhan employees is as follows-
The general outpatient medical expenses incurred by the insured within the scope of the overall fund payment shall be borne by the overall fund and individuals respectively according to the following proportions:
I. On-the-job employees:
1, the proportion of individual payment is 20%, and the proportion of overall fund payment is 80% in the general outpatient service of first-class medical institutions (including township hospitals and community health service institutions);
2. For general outpatient treatment in secondary medical institutions, the proportion of individual payment is 40%, and the proportion of overall fund payment is 60%;
3, tertiary medical institutions general outpatient medical treatment, personal payment ratio is 50%, the overall fund payment ratio is 50%;
Second, retired workers:
1. If the first-class medical institutions (including township hospitals and community health service institutions) seek medical treatment in general outpatient clinics, the proportion of individual payment is 16%, and the proportion of overall fund payment is 84%;
2. For general outpatient treatment in secondary medical institutions, the proportion of individual payment is 32%, and the proportion of overall fund payment is 68%;
3, tertiary medical institutions general outpatient medical treatment, personal payment ratio is 40%, the overall fund payment ratio is 60%.
Note: If the insured uses Class B drugs in the basic medical insurance drug list and Class B drugs in the medical service diagnosis and treatment project list, the individual shall pay 10% first, and the balance shall be subject to the above provisions.
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