1. Who can participate in outpatient co-ordination?

All kinds of insured persons who have participated in Qingdao social medical insurance and paid medical insurance premiums normally according to regulations can sign up for outpatient co-ordination and enjoy the relevant treatment of outpatient co-ordination according to regulations.

2. how to handle the insured's participation in outpatient co-ordination?

the outpatient department shall be managed by fixed-point contract as a whole. Insured employees (including retired and resigned employees) in the city, insured residents in Shinan District, Shibei District, Licang District, Laoshan District, Huangdao District and Chengyang District, and residents in jimo city, jiaozhou city, pingdu city and Laixi City who have signed contracts in non-insured places shall hold their social security cards and independently choose a designated community medical institution (hereinafter referred to as designated community) to enjoy overall outpatient treatment. If the insured chooses jimo city, pingdu city, Laixi and jiaozhou city street (town) hospitals or community health service centers to sign contracts, they can also sign contracts with their integrated management village clinics and enjoy the overall treatment of outpatient service.

Insured people who live in rural areas for a long time can sign up for outpatient service with their social security card in the village clinic, and sign up with the street (town) health center or community health service center at the same time without going to the street (town) health center or community health service center for signing up.

children's signing up for outpatient service shall be handled as a whole according to the above methods, and college students shall be signed by the designated institutions of college students' outpatient service in their respective schools.

3. What is the reimbursement ratio of the insured person's general outpatient medical expenses in the designated community?

the general outpatient medical expenses incurred by the insured in the designated community that meet the scope of outpatient co-ordination payment shall be paid by the basic medical insurance co-ordination fund according to regulations. Among them, 6% of the general outpatient medical expenses incurred by employees' medical insurance participants in designated communities are reimbursed, with a maximum annual reimbursement of 112 yuan; Residents are reimbursed 5% for the first file, and the highest annual reimbursement is 72 yuan; 4% reimbursement for residents' second grade and children, with the highest annual reimbursement for 3 yuan; College students are reimbursed 7%. Among them, the proportion of reimbursement for essential drugs increased by 1 percentage points. The general medical expenses incurred by the insured in signing up for treatment in the designated community run by the government that implements basic drugs are reimbursed at a rate of 9%, and are included in the annual maximum payment limit of my outpatient co-ordination.

4. how to reimburse the medical expenses of the general outpatient service of the insured person in the designated community?

when the insured person goes to the designated community for medical treatment, the general outpatient medical expenses that meet the scope of outpatient co-ordination payment will be reimbursed immediately, and the patient will only pay the expenses that should be borne by himself and sign the receipt. The outpatient and emergency medical expenses incurred by the insured in medical institutions outside the designated community shall not be paid by the overall fund.

5. when will the contracted outpatient coordinator enjoy the treatment? How to determine the medical year of general outpatient service?

the insured who normally enjoys the overall treatment of basic medical insurance will enjoy the overall payment of outpatient service from the date of signing the contract. During the period of unpaid social medical insurance premiums, the insured person does not enjoy outpatient co-ordination treatment, and will not make up the payment after payment. Unsigned insured persons do not enjoy the relevant treatment of outpatient co-ordination.

the general outpatient medical year is from January 1st to December 31st every year. If the insured person signs a contract during the general outpatient medical year, the termination date of the Agreement is December 31st of that year. Upon the expiration of the Agreement, the social security network system will be implemented on January 1, 23 every year.