First, the types of medical insurance and reimbursement ratio
Basic medical insurance for urban workers: Patients who participate in the basic medical insurance for urban workers can enjoy a higher proportion of reimbursement for combined treatment according to the medical insurance policy when seeking medical treatment in Weinan Central Hospital. The specific reimbursement ratio depends on the patient's medical insurance payment period, treatment items and other factors.
Basic medical insurance for urban and rural residents: patients who participate in basic medical insurance for urban and rural residents can also enjoy a certain proportion of reimbursement for combined treatment when they seek medical treatment in Weinan Central Hospital. Compared with the basic medical insurance for urban workers, the reimbursement rate of basic medical insurance for urban and rural residents may be slightly lower, but it can also reduce the economic burden for patients.
Second, the treatment items and reimbursement ratio
The proportion of reimbursement for co-treatment corresponding to different treatment items is also different. Generally speaking, the basic medical insurance will cover the treatment expenses of most common diseases and frequently-occurring diseases, and give corresponding reimbursement. But for some special diseases, high-priced drugs or high-end medical services, patients may have to pay more.
Three, the individual pays part and reimbursement ratio
When patients enjoy the reimbursement treatment of co-governance, they also need to bear a certain proportion of the personal out-of-pocket part. The proportion of personal out-of-pocket part depends on the patient's medical insurance type, treatment items and medical insurance policy. Generally speaking, the lower the proportion of individual pays, the lighter the financial burden of patients.
Fourth, the reimbursement process and matters needing attention
After being treated in Weinan Central Hospital, patients need to go through the relevant reimbursement procedures according to the medical insurance policy. Generally speaking, patients need to submit medical insurance cards, identity cards and other related documents to the hospital when they leave the hospital, and fill in the corresponding reimbursement application form. According to the patient's medical insurance type and treatment items, the hospital will calculate the reimbursement amount that the patient should enjoy, and directly transfer the reimbursement amount to the patient's medical insurance account or bank account. It should be noted that when handling reimbursement procedures, patients need to ensure that the documents and materials submitted are true and effective, otherwise it may affect the smooth progress of reimbursement.
To sum up:
The reimbursement ratio of co-treatment in Weinan Central Hospital varies according to the types of medical insurance, treatment items and individual out-of-pocket expenses. When seeking medical treatment, patients need to know their own medical insurance types and reimbursement policies, and go through relevant procedures according to regulations to ensure that they can enjoy the reimbursement treatment due to joint treatment. At the same time, hospitals should also strengthen publicity and guidance to improve patients' awareness and satisfaction with medical insurance policies and reimbursement processes.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28 stipulates that medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29 stipulates that the part of the medical expenses of the insured that should be paid by the basic medical insurance fund 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.