Foshan urban and rural medical insurance reimbursement ratio in 2019, Foshan urban and rural residents medical insurance reimbursement process.

General outpatient medical insurance reimbursement benefits are that community health service institutions, town (street) health centers and first-level hospitals are classified as first-class medical institutions, with 90% reimbursement; second-class hospitals are classified as second-class medical institutions, with 70% reimbursement; third-class hospitals are classified as third-class medical institutions, with 70% reimbursement.

Class medical institutions, reimbursement 40%.

When the insured goes to a medical institution for general outpatient treatment, the prescribed drug expenses and the regular basic medical service items included in the reimbursement scope (three routine routines, electrocardiogram, black and white B-ultrasound, chest X-ray, and blood sugar monitoring) are borne by the overall fund

Pay according to the following regulations: 90% for community health service institutions, town (street) health centers and first-level hospitals belonging to the first-class medical institutions; 70% for the second-class hospitals belonging to the second-class medical institutions; 70% for the third-class medical institutions

The rate for tertiary hospitals is 40%.

The minimum payment standard for hospitalization medical insurance reimbursement benefits in Gaoming District, and the minimum payment standard for overall fund payment is: 1,200 yuan/time for third-category medical institutions, 600 yuan/time for second-category medical institutions, and 300 yuan/time for first-category medical institutions.

The medical expenses incurred by the insured in designated medical institutions in the city that are above the deductible and included in the payment scope of the overall fund will be paid by the overall fund up to the maximum payment limit according to the type of hospital: 95% for first-class medical institutions and 90% for second-class medical institutions.

Category III medical institutions 85% (funds pay 90% for hospitalization for surgical treatment of malignant tumors, surgical treatment of heart and brain diseases, and liver, kidney and bone marrow transplant surgery).

In terms of outpatient benefits for specific and chronic diseases in Gaoming District, there is no deductible for specific outpatient diseases, and the reimbursement ratio is consistent with the inpatient reimbursement ratio (95% for first-class medical institutions, 90% for second-class medical institutions, 85% for third-class medical institutions, and 85% for major outpatient services).

The reimbursement ratio for extremely serious diseases in Category III hospitals is 90%); the annual limit is divided into three levels, with a low-end limit of 4,500 to 5,500 yuan, a mid-end limit of 40,000 to 45,000 yuan, and a high-end limit of 100,000 yuan.

There is no deductible for outpatient chronic diseases. The reimbursement ratio is 85% for first-class medical institutions, 80% for second-class medical institutions, and 75% for third-class medical institutions. The annual limit is 4,500 to 5,500 yuan.