The proportion of medical insurance reimbursement in Fuzhou varies according to the type of insurance, the place of medical treatment and the medical services received. Generally speaking, Fuzhou medical insurance can cover most medical expenses, but the specific reimbursement ratio needs to be determined according to the medical insurance policy.

I. General situation of medical insurance in Fuzhou

The medical insurance system in Fuzhou aims to provide medical expenses for the insured and reduce the economic burden caused by diseases. The medical insurance fund consists of individual contributions, unit contributions and government subsidies, which are used to pay the medical expenses of the insured.

Second, the reimbursement ratio.

1, hospitalization reimbursement ratio: Fuzhou Medical Insurance has a high reimbursement ratio for hospitalization medical expenses, which can generally reach more than 80%. However, the specific reimbursement ratio will be adjusted according to factors such as hospital level, insured personnel type and medical expenses.

2. Outpatient reimbursement ratio: the reimbursement ratio of outpatient medical expenses is relatively low, generally around 50%. Similarly, the specific reimbursement ratio will also be affected by many factors.

3. Reimbursement ratio of special diseases: For some special diseases, such as malignant tumors and uremia, Fuzhou Medical Insurance Association will provide a higher reimbursement ratio to reduce the economic burden of patients.

Third, the factors that affect the reimbursement ratio

1. Types of insured persons: Different types of insured persons, such as employee medical insurance and resident medical insurance, will have different reimbursement rates.

2. Location of medical treatment: The proportion of medical reimbursement in Fuzhou and other places will also be different.

3. Medical service items: Different medical service items, such as operation fees, examination fees and medicine fees, will have different reimbursement rates.

Fourth, how to increase the reimbursement ratio?

1, understand the medical insurance policy: the insured should understand the medical insurance policies and regulations to ensure that they can enjoy the medical insurance benefits they deserve.

2. Choose a suitable place for medical treatment: when seeking medical treatment, you should choose a designated medical institution with medical insurance to obtain a higher reimbursement rate.

3. Rational use of medical resources: Insured personnel should make rational use of medical resources to avoid unnecessary use of medical services and drugs, so as to reduce medical expenses and increase reimbursement ratio.

To sum up:

The proportion of medical insurance reimbursement in Fuzhou varies according to the type of insurance, the place of medical treatment and the medical services received. Insured persons should know about medical insurance policies and regulations, choose appropriate medical treatment places and make rational use of medical resources in order to improve their medical insurance reimbursement ratio.

Legal basis:

Detailed rules for the implementation of basic medical insurance for urban workers in Fuzhou

Article 25 provides that:

The medical expenses incurred by the insured in the designated medical institutions in accordance with the provisions of the basic medical insurance shall be paid according to the following standards:

(a) general outpatient medical expenses, paid by personal accounts;

(two) hospitalization expenses, paid by the overall fund, a certain proportion of personal burden;

(three) special disease outpatient medical expenses, paid by the overall fund, a certain proportion of personal burden.