Proportion of medical insurance reimbursement for employees in Jilin Province

Hello, you can answer the reimbursement ratio of employee medical insurance from the aspects of reimbursement ratio, general outpatient reimbursement and serious illness reimbursement. 1. The proportion of medical insurance reimbursement for employees (1) is paid according to the first level, 80% of the hospitalization expenses occurred in the first-level hospital that implemented the basic drug system (90% of the basic drug payment), and 60% of the hospitalization expenses occurred in the hospital that did not implement the basic drug system; Secondary hospitals pay 58%; The tertiary hospital pays 45%. (2) According to the second payment, the first-level hospital pays 85% (90% for essential drugs), the second-level hospital pays 70%, and the third-level hospital pays 60%. (three) minor residents and special groups enjoy the medical insurance benefits of class II payment. Qifubiaozhun for reimbursement of hospitalization medical expenses: 300 yuan, a first-class hospital, 500 yuan, a second-class hospital and 700 yuan, a third-class hospital. Malignant tumor patients who have been hospitalized for chemotherapy and radiotherapy for many times in a medical insurance year will only be deducted once. 2. Outpatient medical expenses incurred by the insured workers in the designated community health service centers or township hospitals that meet the requirements shall be paid by the general outpatient co-ordination fund at a rate of 50%. There is no deductible for the general outpatient expenses incurred by the insured workers in the basic medical institutions that implement the national basic drug system; In other primary medical institutions, the minimum payment standard was reduced from 40 yuan to 30 yuan. The reimbursement limit for the first-class general outpatient service was raised from 60 yuan to 80 yuan; The second payment was made in 200 yuan. 3. The treatment of serious illness medical insurance is 20 15 years, and the minimum payment standard of serious illness insurance is10.2 million yuan, that is, after the reimbursement of residents' basic medical insurance, the part of the compliant medical expenses borne by individuals below10.2 million yuan will not be compensated. 50% compensation will be given to the part where the compliance medical expenses borne by individuals exceed 1 .2000 yuan (including1.2000 yuan) and are less than110000 yuan; 65.438+10,000 yuan (including 6.5438+10,000 yuan) and 60% compensation for the part less than 200,000 yuan; More than 200,000 yuan (including 200,000 yuan) will be compensated by 65%. In a medical year, the maximum payment for serious illness insurance is 300,000 yuan per person. In 20 16 years, the standard of 20 15 was still implemented before the new critical illness insurance policy was issued by the relevant departments.