Speaking of medical insurance, I believe everyone is familiar with it. Usually you need to apply for medical insurance when you are hospitalized with a cold and fever. It occupies a very important position in our life. 1.What is the proportion of medical insurance reimbursement in 2022? 1. The reimbursement rate for outpatient service is 50%. Employees who participate in the basic medical insurance for urban workers can only reimburse medical expenses of more than 2,000 yuan after the emergency treatment in the hospital. For retirees under the age of 70, the expenses above 1300 yuan can be reimbursed, and the reimbursement rate is 70%. For retirees over 70 years old,180% of the expenses above 300 yuan can be reimbursed. No matter what kind of people, the maximum payment limit for outpatient and emergency medical expenses is 20 thousand yuan. For example, if you are an on-the-job employee, and the outpatient medical expenses are 2,500 yuan, then this 500 yuan can be reimbursed 50%, that is, 250 yuan. 2. Proportion of reimbursement for hospitalization At present, when the basic medical insurance is used for the first time in a year, the minimum payment for both employees and retirees is 1.300 yuan. And the second and subsequent hospitalization medical expenses, Qifubiaozhun is determined by 50%, which is 650 yuan. The maximum annual payment limit (hospitalization expenses) of the basic medical insurance pooling fund is currently 70,000 yuan. Second, what does not belong to the scope of medical insurance reimbursement At present, there are five types of medical treatment projects that are not included in the catalogue of urban basic insurance treatment projects, including service projects, non-disease treatment projects, medical treatment equipment and medical materials, and treatment projects. In addition to the cost of orthodontics, medical insurance does not reimburse non-disease treatment items, that is, various cosmetic plastic surgery; All expenses of various weight loss, weight gain and projects; Prevention, project; All kinds of non-therapeutic consultation and appraisal fees; Diagnosis and treatment equipment and medical materials, that is, inspection and treatment projects carried out by large equipment such as ophthalmic excimer laser therapeutic apparatus; All kinds of self-use, massage, procuratorial and therapeutic instruments; The price part stipulates disposable medical materials that cannot be charged separately. 3. What are the specific inquiry methods of medical insurance? 1. For local inquiry, the insured person can directly bring his ID card and resident medical insurance card to the service hall of the local social security bureau to print the payment list, and then you can inquire about relevant information in detail. This way is more direct, suitable for those who can't surf the Internet and help themselves by telephone, and those who have time are more suitable for the elderly at a certain age. 2. Telephone inquiry The insured can directly call the Social Security Bureau (12333) for inquiry. According to the voice prompts, you need to enter the social security card number and account password. This query method is also more convenient and fast, and it is the first choice of many people. 3. online inquiry online inquiry is suitable for people who know computer operation and don't have much leisure time. First, find the website of the local social security bureau online, open the website page, and enter personal information such as personal social security card account number, inquiry password and ID number, so that you can find your latest account information conveniently and quickly. The above is the whole content of this paper, from which we can know what the proportion of medical insurance reimbursement is in 2022, which are not within the scope of medical insurance reimbursement, and what are the specific inquiry methods of medical insurance. They are online 24 hours a day and can answer your legal questions at any time.
Legal objectivity:
What is the proportion of medical insurance reimbursement? This is a very complicated problem, not to mention that the medical insurance policy has various regulations due to different regions, and even there are many kinds of medical insurance drugs. In addition, the ratio of outpatient reimbursement to hospitalization reimbursement is really difficult to calculate. 1. Different hospitals have different reimbursement rates for medical insurance. A person spends 10000 yuan in a hospital. If he is hospitalized in a first-class hospital, 500 yuan will be deducted first; If you are hospitalized in a secondary hospital, first subtract 1000 yuan; If you are hospitalized in a tertiary hospital, you will be reduced by 2000 yuan first; After excluding "non-medical insurance drug expenses" and "other non-medical insurance expenses", the remaining employees reported 80%, retired or unemployed, and unemployed 50%. Note: Medical insurance reimbursement only covers Class A drugs, that is, medical insurance drugs, and Class B drugs are not medical insurance and cannot be reimbursed. 2. On-the-job employee hospitalization medical insurance reimbursement ratio hospitalization, except for the self-funded part and self-paid 10%, the part exceeding the deductible of hospitalization medical insurance enjoys the overall payment ratio. Different levels of hospitals have different threshold fees and enjoy different proportions of overall payment. The proportion of medical insurance for employees is over 80% (82%/84%/87% in Wuhan), and that for residents is about 70% (80%/65%/50% in Wuhan). From this perspective, the proportion of self-funded medical insurance hospitalization is hard to say. All self-funded parts are self-funded, and all threshold fees are self-funded. The second-class expenses shall be paid by 65,438+00% first, and then by 20% together with the first-class expenses. Very complicated! In fact, the computer system will automatically calculate. Medical insurance hospitalization, show the medical insurance card, read the card into the medical insurance system, pay the deposit (usually the threshold fee), and enter the fee into the system. The system automatically classifies it as self-funded, Class A, Class B, etc. Class B pays 65,438+00% first, and then enters the basic medical care. According to the number of hospitalizations per year (more than 1 deductible expenses are halved) and hospital level (deductible expenses are different), the calculation formula is as follows: if the medical expenses total 9,000 yuan, the reimbursement formula is [9000-500 (deductible expenses)-self-funded drugs ]*80%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed. 3. Proportion of reimbursement of supplementary medical insurance for retirees. Ms. Zhang, who lives in Shijingshan District, Beijing, reported that after retiring in 2000, she had to go to the hospital for a prescription every month because of chronic diseases. In the past, the reimbursement rate was always about 88% (for retirees under 70 years old, 70% of large medical expenses were paid by mutual funds, and 60% of the remaining 30% could be reimbursed by supplementary medical insurance, which was 88%). But now it is said that the proportion of supplementary medical insurance in social security card (that is, medical insurance card) is 50%, so only 85% can be reimbursed. She wants to know whether the social security card has adjusted the proportion of medical reimbursement. The staff of the Social Security Bureau replied that the social security card did not adjust any medical reimbursement ratio. According to the Regulations of Beijing Municipality on Basic Medical Insurance issued in 2005, the social supplementary medical insurance for retirees under 70 years old is 50%. If the reimbursement rate of Ms. Zhang's supplementary medical insurance is 60%, it should be because the funds reimbursed by Ms. Zhang's original unit are higher than the social supplementary medical insurance. After using the social security card, it can still be reimbursed according to the reimbursement ratio provided by the original unit, that is, 60% of the supplementary medical insurance.