General outpatient reimbursement

1. You must go to the medical institution designated by the scientific research institute in the university.

2 outpatient reimbursement rate of not less than 70%, the annual payment limit is not less than 400 yuan.

3. With the consent of the school hospital, the expenses for outpatient medical treatment in other designated medical insurance service institutions shall be reimbursed by the school hospital according to regulations.

Hospitalization reimbursement

1. The hospitalization medical expenses of college students who meet the above requirements of Qifubiaozhun shall be shared by medical insurance funds and individuals in proportion. Expenses below hospitalization Qifubiaozhun shall be paid by individuals.

2. The Qifubiaozhun for college students' medical insurance hospitalization benefits shall be implemented according to the tertiary medical institution 800 yuan, the secondary medical institution 400 yuan and the primary medical institution 200 yuan (if the level of community health service center is higher than the first level, the first-level standard shall be implemented).

3. Among them, in an insurance year, college students in our city are hospitalized in secondary and tertiary medical institutions, and if they are hospitalized for the first time, the Qifubiaozhun will be implemented according to 100%; Starting from the second hospitalization, Qifubiaozhun will be halved.

4. Transfer between designated medical institutions (departments) shall be regarded as a hospitalization, and the Qifubiaozhun of high-grade medical institutions shall be implemented, and the proportion of hospitalization payment for transfer-out and transfer-in medical institutions shall be implemented respectively.

5. The reimbursement rate for hospitalization is: 60% for tertiary medical institutions; 70% of secondary medical institutions; 90% of first-level medical institutions and community health service centers (if the level of community health service centers is higher than the first level, the first-level payment ratio will be implemented).

6 pregnant women who meet the birth policy among college students in our city are paid by the residents' medical insurance fund according to the highest standard of 700 yuan/time.

7 outpatient emergency rescue after hospitalization, the emergency rescue expenses into the hospitalization expenses.

8. Within an insurance year, the maximum reimbursement for college students' hospitalization basic medical insurance is 6.5438+0.5 million yuan.

Serious (chronic) diseases

1. The diagnosis certificates and medical records of students recently treated by universities and scientific research institutes shall be submitted to the medical insurance agency in the district where they are located to go through the formalities of serious illness declaration.

2 district medical insurance agencies designated medical institutions to identify the condition of college students.

3 in accordance with the provisions, determine a designated medical institution for medical insurance benefits.

4. You must bring your ID card and special outpatient medical records for serious illness when you buy medicine for medical treatment.

5. 70% of the expenses that meet the requirements of outpatient intensive care for college students will be reimbursed.

Reimbursement for hospitalization in different places

1. The hospitalization expenses in different places shall be paid in advance by myself.

2. Within 90 days after the end of treatment, the relevant materials held by universities and research institutes shall be reviewed and reimbursed by the medical insurance agencies in all districts within the specified time.

critical illness insurance

College students participate in the medical insurance for urban and rural residents in our city and enjoy the treatment of serious illness insurance at the same time. Within the scope of the medical insurance policy in one year, the part that the individual pays more than 6.5438+0.2 million will be paid in proportion, and the annual maximum payment limit is 300,000 yuan.

legal ground

People's Republic of China (PRC) social insurance law

Article 73 Social insurance agencies shall establish and improve business, financial, safety and risk management systems. Social insurance agencies shall pay social insurance benefits in full and on time. ;

Eighth social insurance agencies to provide social insurance services, responsible for social insurance registration, personal rights and interests records, social insurance benefits payment and other work.

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.