75% of the large amount of supplementary medical insurance for insured employees will be paid by the fund of 1,-3, yuan (including 3, yuan) and 85% by the fund of 3,-5, yuan, which will be uniformly increased to 9%. That is, within a natural year, the expenses incurred by the insured workers in hospitalization (including outpatient special diseases) can be paid by the fund, which exceeds the maximum payment limit of the basic medical insurance co-ordination fund, and 9% of the annual accumulated amount is less than 5, yuan (including 5, yuan). Since January 1, 221, the insured workers have been hospitalized in the third-level (formerly provincial) designated medical institutions, and the minimum threshold has been reduced from 1,5 yuan to 1,2 yuan. The third-level (formerly municipal) designated medical institutions have been reduced from 1 yuan to 7 yuan, the second-level (formerly county-level) designated medical institutions have been reduced from 7 yuan to 4 yuan, and the first-level and below (formerly community health service centers and township hospitals) designated medical institutions have been reduced from 3 yuan to 2 yuan. The procedure of seeing a doctor is as follows: when the insured is sick, he holds the medical insurance manual and IC card. You can go directly to the local designated medical institutions for treatment. The general procedures are: holding the medical insurance manual and IC card-registering with the hospital medical insurance office-examining and verifying the card-paying the hospitalization deposit-staying in the hospital-agreeing and signing the self-funded items with the patient's consent-settling the deductible standard and the self-paid part of the self-paid ratio with cash or IC card-paying expenses in advance by the hospital within the overall scope-settling and discharging.
The settlement of hospitalization expenses adopts the post-paid service item settlement method. (1) Enrolment. Medical institutions can only charge them the following fees: Qifubiaozhun fee, bed fee exceeding the prescribed standard, the individual should bear the proportional part of the fee, the fee for using the project at his own expense, and the fee not covered by the overall fund. The above fees can be paid by personal account, and the insufficient part can be paid by personal cash. The fees paid by the overall fund shall be settled by medical institutions and medical insurance departments.
(2) The bed fee for hospitalization shall be paid according to the prescribed standard;
(3) In case of hospitalization for more than two times in a year, the deductible line shall be 5% of the deductible standard of this year from the second time;
(4) When the insured is discharged from the hospital, the medical insurance office of the designated medical institution shall print out the list of all expenses in triplicate, one for the medical institution, one for the medical insurance institution and one for the insured.
(5) There are also specific provisions for emergency treatment and medical treatment for those who have settled down in other places.