The reimbursement formula is: (12,000 - the amount of the deductible - self-paid drugs) * 65%, (6,000 - the amount of the deductible - self-paid drugs) * 75%. If self-paid drugs account for a large proportion, there will not be much reimbursement.
amount.
The reimbursement ratio of urban residents' medical insurance is related to the hospital level: the minimum payment amount for a third-level hospital is 600 yuan, and the proportion is 65%; the minimum payment amount for a second-level hospital is 400 yuan, and the proportion is 75%; the minimum payment amount for a first-level hospital is 200 yuan,
The proportion is 85%; the minimum payment amount for cross-province co-ordination is 600 yuan, and the proportion is 65%; the minimum payment amount for cross-province co-ordination is 600 yuan, and the proportion is 55%.
Urban residents' medical insurance is a medical insurance system that mainly covers minors and residents who have not participated in employee medical insurance. The reimbursement ratios of medical insurance are also different in different situations.
60% reimbursement for visits to village clinics and village center clinics.
40% reimbursement for medical treatment at the town health center.
30% reimbursement for visits to secondary hospitals.
20% reimbursement for visits to tertiary hospitals.
The traditional Chinese medicine invoice attached to the prescription has a limit of 1 yuan per prescription.
The annual compensation limit for town-level cooperative medical outpatient clinics is 5,000 yuan.
Expanded information: Scope of reimbursement: Medication fees: Auxiliary examinations: EEG, X-ray, film, laboratory tests, physical therapy, acupuncture, CT, MRI and other examination fees are limited to 200 yuan; surgery fees (refer to the national
Standard, if the amount exceeds 1,000 yuan, it will be reimbursed at 1,000 yuan).
Elderly people over 60 years old who are hospitalized in the town health center will be compensated 10 yuan per day for treatment and nursing fees, with a limit of 200 yuan.
Compensation for serious illnesses and town-level risk fund compensation: all inpatients participating in cooperative medical care whose one-time or annual cumulative medical expenses exceed 5,000 yuan will be compensated in stages, that is, 65% will be compensated for 5,001-10,000 yuan, and 70% will be compensated for 10,001-18,000 yuan.
, the annual limit of compensation for town-level cooperative medical inpatient and uremia outpatient hemodialysis, cancer outpatient radiotherapy and chemotherapy is 11,000 yuan.