Maximum reimbursement for urban residents' medical insurance
Outpatient reimbursement: 2,000 yuan
Hospitalization reimbursement: 170,000 yuan
Maximum reimbursement for urban workers' medical insurance
Outpatient reimbursement: 20,000 yuan
Hospitalization reimbursement: 300,000 yuan
Expanded information
Reimbursement coverage
I. Scope of medical treatment items for which basic insurance does not cover the expenses
(I) Service item category
1, registration fee, out-of-hospital consultation fee, and cost of medical records;
2, consultation fee, expedited fee for examination and treatment (except for emergencies), surcharge on named surgeries, high quality and excellent price, and fee for self-employed special nurses, and other medical services for special needs.
(2) non-disease treatment program category
1, a variety of cosmetic (cosmetic life, medical cosmetic) fitness program and messy non-functional cosmetic surgery, orthopedic surgery, etc.;
2, a variety of weight loss, weight gain, height projects.
3, a variety of health checkups.
4, a variety of preventive, health care treatment programs.
5, dental orthodontics, dental porcelain.
6, a variety of medical consultation (excluding psychiatric consultation), medical appraisal.
(C) diagnostic and therapeutic equipment and medical materials
1, the application of positron emission tomography device, electron beam CT, ophthalmic excimer laser therapy instrument and other large-scale medical equipment for the inspection and treatment program
2, glasses, dentures, prosthetic eyes, prosthetics, hearing aids and other rehabilitative appliances.
3, a variety of self-use health care, massage, examination and rehabilitation and treatment equipment.
(D) therapeutic project category
1, all kinds of organ transplantation or tissue transplantation of organ source or tissue source;
2, in addition to kidney, heart valves, cornea, skin, blood vessels, bone, bone marrow transplantation of other organs or tissues
3, myopic orthopaedics
4, qigong therapy, music therapy, health care nutritional therapy , magnetic therapy and other complementary therapeutic programs.
(E) other
1, a variety of infertility (pregnancy), sexual dysfunction treatment program
2, a variety of scientific research, clinical verification of the treatment program.
Basic medical insurance to pay part of the cost of the scope of treatment programs
(a) diagnostic and treatment equipment and medical materials
1, the application of X-ray computed tomography (CT), stereotactic radiography (γ-knife, χ-knife), cardiography and angiography X-ray device (γ-knife, χ-knife). X-ray machine (including digital subtraction equipment), cardiac and angiographic X-ray machine, magnetic **** vibration imaging device (MEI), single photon emission computerized scanning device (SPECT), color Doppler, medical linear gas pedal and other large-scale medical equipment for the examination and treatment of the project;
2, extracorporeal shockwave lithotripsy and hyperbaric oxygen therapy
3, pacemakers, Artificial joints, artificial crystals, vascular stents within the replacement of artificial organs, materials placed in the body
4, the provincial pricing department of the provisions of the disposable medical materials can be charged separately.
(B) treatment project category
1, hemodialysis, peritoneal dialysis
2, kidney, heart valve, cornea, skin, blood vessels, bone, bone marrow transplantation
3, cardiac laser perforation, anti-tumor cellular immunotherapy and fast neutron therapy projects.
(3) examination and treatment items of medical instruments and equipment and medical materials with a single cost of more than 400 yuan.