1. For students and children seeking medical treatment in Tianjin, the reimbursement rate is 80% in first-class hospitals, 75% in second-class hospitals and 65% in third-class hospitals;
2. The reimbursement rate of high-grade medical services is 80% in first-class hospitals, 75% in second-class hospitals and 65% in third-class hospitals;
3. The reimbursement rate of mid-range medical services is 75% in first-class hospitals, 70% in second-class hospitals and 65% in third-class hospitals;
4. The reimbursement rate of low-grade medical services is 70% in first-class hospitals, 65% in second-class hospitals and 55% in third-class hospitals.
Medical insurance reimbursement process:
1, patients with medical insurance card to the designated medical institutions;
2. Medical institutions provide corresponding medical services according to the patient's condition;
3. After seeing a doctor, the medical institution will settle the patient's medical expenses through the medical insurance system;
4. The medical insurance system automatically calculates the reimbursement amount according to the patient's medical insurance policy and personal account;
5. The patient pays the personal burden, and the medical insurance is paid directly to the medical institution by the medical insurance fund.
To sum up, the proportion of medical reimbursement in Tianjin varies according to the level of medical services. The proportion of reimbursement in first-class hospitals is higher, followed by second-class hospitals and third-class hospitals.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.