First-class hospitals: 75% reimbursement for the part of medical expenses from 800-5500 yuan; 55% reimbursement for the part of 5500-7500 yuan;
Second-class hospitals: 65% reimbursement for the part of medical expenses from 800-5500 yuan; 55% reimbursement for the part of 5500-7500 yuan;
Third-class hospitals: uniformly reimbursed by 55% reimbursement; Pharmacy: 65% reimbursement for the $800-$5,500 portion; 55% reimbursement for the $5,500-$7,500 portion.
Outpatient special diseases: 85% reimbursement for the part of 1,300 yuan-120,000 yuan; 80% reimbursement for the part of 120,000-450,000 yuan. Reimbursement of hospitalization expenses (annual limit of $450,000) Hospitalization expenses are reimbursed at a flat rate of 85% for the portion of hospitalization expenses from the starting line - $120,000; 80% for the portion of hospitalization expenses from $120,000 - $450,000.
One, the medical insurance card is used up money can be reimbursed, the specific reimbursement rate by the local social security bureau, the medical insurance medical expenses reimbursement amount is directly in the discharge settlement from the total amount of money deducted, not to the card, the individual needs to pay for reimbursement of the out-of-pocket expenses part. If you don't have a balance on your card, you'll have to pay out of pocket.
Two, outpatient and emergency medical expenses: the portion of medical expenses exceeding 2,000 yuan in total that meet the scope of basic medical insurance within the year (January 1~December 31) of an active employee. Settlement ratio: 50% reimbursement for the part over 2000 RMB for dispatched staff during the contract period, and 50% out-of-pocket payment by individuals; the maximum amount of outpatient and emergency reimbursement paid to dispatched staff is 20,000 RMB cumulatively in a year. Participants should keep the outpatient medical receipts (including receipts and prescription bottoms for the portion below the large amount) of the outpatient consultation at the designated hospitals as the vouchers for reimbursement of medical expenses. Outpatient medical treatment for three special diseases: when a participant suffering from malignant tumor radiotherapy and chemotherapy, renal dialysis, or taking anti-rejection drugs after kidney transplantation needs outpatient medical treatment, the second or third level designated hospital where the participant seeks medical treatment will issue a certificate of diagnosis of the disease and fill in the form of "Declaration of Approval for Special Diseases in Medical Insurance", and report it to the District Medical Insurance Center for approval and filing. Legal Basis: The Social Insurance Law of the People's Republic of China Article 2 The State establishes a social insurance system for basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance and other social insurance, and guarantees the right of citizens to obtain material assistance from the State and society in accordance with the law in the event of old age, sickness, industrial injury, unemployment and maternity. Article 26 The standards of treatment for basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the provisions of the State. Article 28 Medical expenses in conformity with the basic medical insurance drug catalog, diagnostic and treatment items, standards of medical service facilities, as well as emergency and rescue medical expenses shall be paid out of the basic medical insurance fund in accordance with the state regulations