1, Qifubiaozhun: tertiary hospital 800 yuan, secondary hospital 600 yuan, other 300 yuan;
2. Reimbursement ratio:
A, Qifubiaozhun to 40,000 yuan: 82% of tertiary hospitals are employed and 86% are retired; 84% of secondary hospitals are in service and 88% are retired; The other 86% are working and 90% are retired; 88% are in the community and 93% are retired;
B, 40,000-240,000 yuan: 88% of tertiary hospitals are in service and 94% are retired; 90% of secondary hospitals are in service and 95% are retired; 92% are engaged in other/community work and 96% are retired;
C, more than 240,000 yuan: 88% in tertiary hospitals, 90% in secondary hospitals, and 92% in other/community.
Outpatient reimbursement standard
1, minimum payment standard: employee 1000 yuan, enterprise retiree 300 yuan, other retiree 700 yuan, former employee 1949, 20 10, July 1 No minimum payment standard is set.
2. Reimbursement ratio:
A tertiary medical institutions: 76% of employees and 82% of retirees;
B secondary medical institutions: 80% of employees and 85% of retirees;
C. Other medical institutions: 84% are employed and 88% are retired;
D. Community health service institutions: 88% are employed and 92% are retired.
The conditions for medical insurance reimbursement are:
1, the insured person must go to the designated medical institution of basic medical insurance or the designated retail pharmacy determined by the social insurance institution with the medical prescription issued by the doctor in the designated hospital.
2. The medical expenses incurred by the insured in the process of medical treatment must conform to the scope and payment standards of the basic medical insurance drug list, medical treatment items and medical service facilities standards, and can be paid by the basic medical insurance fund according to regulations.
3. The medical expenses incurred by the insured that meet the payment scope of basic medical insurance shall be paid by the social medical pooling fund in a unified proportion, with the expenses above the Qifubiaozhun and below the maximum payment limit.
Documents required to obtain a medical insurance card:
1. If the enterprise helps employees to get it, it is required to provide a copy of the ID card of the person receiving the medical insurance card, a copy of the ID card of the person who needs to get it and the official seal of the enterprise;
2. Individuals who receive medical insurance cards by themselves need to provide payment vouchers, card-taking vouchers and original ID cards;
3. If it is collected by others, the original ID card and power of attorney of the consignee shall be provided.
Legal basis: People's Republic of China (PRC) Social Insurance Law.
Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.
Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.