From 20 19 65438+ 10/month, Beijing adjusted the maximum payment limit for hospitalization of urban workers and urban and rural residents. After the adjustment, the maximum payment limit of basic medical insurance for employees and retirees participating in the basic medical insurance for urban employees will be raised from 300,000 yuan to 500,000 yuan. In other words, the hospitalization fee can reach the top line of 500 thousand.

Even if it exceeds the ceiling line of 500,000, the expenses that meet the policy scope will be reimbursed, and the expenses that the insured exceeds the original maximum payment limit will be reimbursed before the system goes online.

With the efforts of designated hospitals and medical insurance agencies in the city, the insured person who exceeds the original maximum payment limit will be reimbursed, and the amount of reimbursement will be directly credited to the insured person's bank account through the bank. At present, the insured persons in Chaoyang, Fengtai, Changping and other districts have paid in the near future, and other insured persons will pay in succession.

The insured who has not received the overdue payment can also contact the local social security agency through the unit or the social security office.

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Extended data:

The "upgrade" of fraudulent insurance means will explore mechanisms such as face recognition technology, medical information interconnection, collection and comparison of hospitalization registration time, synchronous collection of purchase and sale information of medicines and consumables in medical institutions, and investigation and comparison of medical insurance payment information and tax payment information, which will be deeply applied to outpatient service, hospitalization and background monitoring.

According to national requirements, maternity insurance and employee medical insurance should be merged this year, and the funds should be used uniformly. After the comprehensive two-child policy, the city's maternity insurance fund has been unable to make ends meet for two consecutive years. After the implementation of the merger, it is estimated that the medical insurance fund expenditure will increase by 2 billion yuan every year. The third is to implement the comprehensive reform of medical consumption linkage. Even according to the static data of 20 18, the annual expenditure of the fund will increase by more than 2 billion yuan.

At the same time, it will cost more than 500 million yuan to raise the maximum hospitalization limit for employees, raise the psychiatric hospitalization quota standard and adjust the payment standard for single diseases.

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