1. When the basic medical insurance is used for payment for the first time in a year, the minimum payment for both employees and retirees is 1300 yuan;
2, the second and later hospitalization medical expenses, Qifubiaozhun determined by 50%, namely 650 yuan;
3. The maximum payment limit of the basic medical insurance pooling fund within one year is 70,000 yuan.
Basic policies of medical insurance:
1. medical insurance reimbursement scope: compliant medical expenses include medicine expenses, medical treatment expenses, examination expenses, bed fees, etc. ;
2. Medical insurance reimbursement process: the insured person goes to the designated medical institution for medical treatment, and directly swipes the medical insurance card for settlement when leaving the hospital. After the individual pays part of the expenses, the rest will be paid by the medical insurance fund;
3. Medical insurance reimbursement ratio: According to different levels of medical institutions, treatment items, drug types and other factors, the reimbursement ratio is different, usually between 50% and 90%;
4. medical insurance capping line: set an annual medical expense reimbursement ceiling, and the excess will be borne by individuals;
5. medical insurance deductible line: set the starting point of personal annual medical expenses, and expenses below deductible line will not be reimbursed.
6. Designated hospitals for medical insurance: Insured persons need to seek medical treatment in designated hospitals within the medical insurance agreement, and expenses incurred in non-designated hospitals are generally not reimbursed.
7. Special disease policy: For special diseases, the medical insurance department will have a special reimbursement policy, and the proportion will usually be higher.
8. reimbursement for medical treatment in different places: the reimbursement process and proportion may be different for medical treatment in different places, and it is necessary to know the local medical insurance policy in advance.
9. Annual settlement of medical insurance: medical insurance accounts are settled at the end of each year, and unused medical insurance funds are disposed of according to regulations.
10. Personal medical insurance account: The personal medical insurance account of the insured person can be used to pay for some self-funded drugs and medical services.
The above information is for reference only. Please consult the local medical insurance department or consult the latest medical insurance policy documents for the specific reimbursement ratio and policy.
To sum up, the reimbursement rate of medical insurance in Guiyang is: when using basic medical insurance for the first time, the minimum payment is 1300 yuan; The minimum qifubiaozhun for the second and subsequent hospitalization expenses is 50%, that is, 650 yuan; The maximum payment limit of the basic medical insurance fund is 70 thousand yuan.
Legal basis:
Regulations of People's Republic of China (PRC) Municipality on Basic Medical Insurance for Urban Workers
Article 29
The hospitalization expenses for major diseases are paid in the following ways:
Qifubiaozhun is controlled in principle at 9%- 1 1% of the average social wage of employees in cities, counties and autonomous counties in the previous year.
In principle, the maximum payment limit is controlled at 3-5 times of the average social wage of employees in cities, counties and autonomous counties in the previous year.
Medical expenses above Qifubiaozhun and below the maximum payment limit are mainly paid by the overall fund, and individuals bear a certain proportion. Give appropriate care to the proportion of retirees who bear medical expenses.
The scope of serious diseases, the specific standards of Qifubiaozhun and the maximum payment limit, and the proportion of sharing medical expenses above Qifubiaozhun and below the maximum payment limit shall be determined by the provincial people's government.