What is the reimbursement ratio of Taian medical insurance? This is determined according to the identity of the reimbursement population and the level of the treatment hospital. The reimbursement rate for general outpatient service of urban residents is 50%, and that for general outpatient service of urban workers is 60%.
townee
Qifubiaozhun
First-class standard payment
Level-1 hospital 200 yuan, level-2 hospital 600 yuan, level-3 hospital 1000 yuan.
Second-level standard payment
The first-level hospital is 200 yuan, the second-level hospital is 400 yuan, and the third-level hospital is 800 yuan.
Reimbursement ratio
Medical expenses above Qifubiaozhun within the scope of overall payment,
The proportion of the insured paying the first-class expenses is 85% in the first-class hospital (90% for essential drugs), 70% in the second-class hospital and 55% in the third-class hospital.
The proportion of the insured who pay the second level is 85% in the first-level hospital (90% for essential drugs), 75% in the second-level hospital and 65% in the third-level hospital.
General outpatient service
Reimbursement ratio: 50%
1. The annual payment limit for medical treatment is 500 yuan.
Outpatient medical expenses of medical institutions: 80% paid by the outpatient co-ordination fund.
Urban workers
Qifubiaozhun
The first-level hospital is 300 yuan, the second-level hospital is 400 yuan, and the third-level hospital is 500 yuan.
Reimbursement ratio
Workers and staff
For the part below 1. 10000 yuan (including 10000 yuan), the overall fund will pay 80% and the individual will bear 20%.
2. 10000 yuan to 20000 yuan (including 20000 yuan), 85% from the overall fund and 0/5% from the individual.
32,000 yuan to 30,000 yuan, 90% of the overall fund, personal burden 10%.
retiree
For the part below 1. 10000 yuan (including 10000 yuan), the overall fund will pay 85%, and the personal burden will be 15%.
2. 10000 yuan to 20000 yuan (including 20000 yuan), the overall fund pays 90%, and the personal burden 10%.
32,000 yuan to 30,000 yuan, 95% from the overall fund and 5% from the individual.
General outpatient service
Proportion: 60% of general outpatient medical expenses incurred by employees participating in medical insurance in designated communities are reimbursed, with the highest annual reimbursement for 800 yuan and 900 for retirees.
Outpatient medical expenses of medical institutions: 80% paid by the outpatient co-ordination fund.
Tip: The proportion of medical insurance reimbursement in Tai 'an is determined by different levels of reimbursement according to the identity of the reimbursement population. It should be noted that for retired employees, the compensation given by the state is even greater, with a minimum compensation of 85%.