Many employees who pay medical insurance know that they can enjoy medical insurance reimbursement after hospitalization. They can use the medical insurance office to pay medical expenses, or they can use the medical insurance card to buy medicines. But many people don't know what the hospitalization standard of medical insurance is. Due to the different implementation standards of medical insurance benefits in different provinces. Recently, I sorted out the medical insurance reimbursement standards in various provinces and explained them one by one with some cases.

In this issue, I will take you to see: the medical insurance treatment standard for on-the-job and retirees in Jiangsu Province!

First, the basic situation of medical insurance for employees in Jiangsu Province

1. Number of participants

By the end of 2020, the number of employees participating in medical insurance in Jiangsu Province was 31022,500, an increase of 654,380+0,482,000 compared with 20 19, with a growth rate of 5.0%; Among them, there are 22,966,400 employees and 8,054,338 retirees.

2. Income and expenditure of employee medical insurance fund

In 2002, the income of medical insurance (including maternity insurance) fund for employees in the province was 65.438+02.796 billion yuan, the expenditure was 65.438+06.5438+0055 billion yuan, and the accumulated balance was 99.493 billion yuan. Overall, Jiangsu's income is greater than its expenditure, with a slight balance.

II. Hospitalization medical insurance benefits for employees in Jiangsu Province

Regarding the medical insurance hospitalization treatment of employees in Jiangsu Province, there are slight differences among the cities under its jurisdiction, and the latest medical insurance hospitalization treatment of employees in each city shall prevail. Let's take Nanjing as an example and make a concrete analysis for reference only.

1. Qifubiaozhun

(1) Level I hospital: 300 yuan.

(2) Level II hospital: 500 yuan.

(3) tertiary hospital: 1000 yuan.

It should be pointed out that:

For the second hospitalization in the same year, the minimum Qifubiaozhun is reduced by 50%, and the third Qifubiaozhun is exempted.

For example:

Uncle Wang, he is admitted to a tertiary hospital for the first time, and the minimum compensation is 1000 yuan; The second time I was admitted to a tertiary hospital, the threshold was 500 yuan; The third time I was admitted to a tertiary hospital, the minimum threshold was 0 yuan.

2. Proportion of individual contributions

(1) Level-I hospitals: 3% for employees and 2% for retirees.

(2) Secondary hospitals: 5% for employees and 3% for retirees.

(3) Tertiary hospitals: the proportion of individual contributions of employees is 10%, and that of retirees is 7%.

Relatively speaking, in the same hospital, the proportion of individual contributions of retirees is lower than that of on-the-job personnel.

Uncle Zhang is a retiree. When I was admitted to a secondary hospital for the first time, my personal medical expenses totaled 20,000 yuan, of which 5,000 yuan belonged to the medical expenses outside the overall planning. Then, how much can the medical insurance fund reimburse when Uncle Wang is hospitalized?

Write at the end:

1. The hospitalization qifubiaozhun for insured employees in Nanjing, Jiangsu Province is related to the hospital level. The higher the grade, the higher the minimum payment standard. The lowest 300 yuan, the highest 1000 yuan.

2. The proportion of individual contributions of medical insurance for insured employees in Nanjing, Jiangsu Province is related to the identity of the insured. In the same hospital, the proportion of individual contributions of retirees is lower than that of employees.

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