Tianjin retail pharmacy medical insurance drug reimbursement policy

Recently, the temperature in Tianjin has been fluctuating between high and low

leading to many friends catching colds easily

but I also found out

in fact, there are some minor illnesses in the daily life

quite a lot of friends are too lazy to go to the hospital

but are used to go to the drugstore to buy medicine

in order to make it more convenient for everyone to buy medicine

Recently, Tianjin Municipal Bureau of Healthcare website

announced

two batches of new health insurance fixed-point

retail pharmacies, medical institutions

***41

Come and see if there are any of your doorstep. Retail pharmacies, medical institutions

***41

Come and see, there is no your doorstep it!

Municipal Medical Insurance Center on Tianjin Long_Hebinshui Drug Sales Co., Ltd. and other 33 new fixed-point retail pharmacies to sign the medical insurance service agreement Announcement

In accordance with the relevant provisions of the Tianjin Municipal Medical Insurance, Tianjin Long_Hebinshui Drug Sales Co, Ltd. and other 33 retail pharmacies have been assessed and qualified, and have completed the installation and debugging of the information system of the pharmaceutical procurement application platform, supervision and inspection facilities and equipment, and have signed the "Tianjin Medical Protection Designated Retail Pharmacy Medical Service Agreement".

List of designated retail pharmacies that have signed the medical insurance service agreement:

Announcement of the Municipal Medical Insurance Center on the signing of the medical insurance service agreement by 8 new designated medical institutions, such as the Tianjin Hexi Haomei Dental Clinic

In accordance with the relevant provisions of Tianjin's medical insurance, 8 medical institutions, such as the Tianjin Hexi Haomei Dental Clinic, have signed the medical insurance service agreement with the Tianjin Medical Insurance Center. In accordance with the relevant provisions of the Tianjin Municipal Medical Insurance, eight medical institutions, including Tianjin Hexi Haomei Dental Clinic, have completed the installation and commissioning of the information system of the pharmaceutical procurement application platform, supervision and inspection facilities and equipment, and have signed the "Tianjin Municipal Medical Insurance Designated Pharmaceutical Institutions Medical Service Agreement" after being assessed and qualified.

Signing a health insurance service agreement designated medical institutions list:

Speaking of medical care, I also found a thing

That is, a lot of partners

on the Tianjin health insurance reimbursement ratios

is not quite understand

The thoughtful editorial for you to organize a good

Resident health insurance and employee health insurance reimbursement ratios.

It's a good idea to collect them now!

The participants of the family doctor contracted with the primary health care institutions, from the month after the contract, the individual outpatient medical insurance amount increased by 200 yuan, the payment ratio increased by five percentage points. The specific measures are implemented in accordance with the current policy of the residents' health insurance.

In a year, the insured person is hospitalized (including outpatient specific diseases), after reimbursement by the basic medical insurance, the policy scope of the individual burden of medical expenses above the starting line, 300,000 yuan (including) the following medical expenses, in accordance with the provisions of the residents of the major disease insurance coverage.

Starting line: 50% of the per capita disposable income of the previous year. For medical aid recipients and those who receive regular pension benefits (meaning those who receive medical assistance), the starting line for residents' major medical insurance is reduced by 50% from that of the general population, the reimbursement rate is increased by 5 percentage points, and the ceiling is abolished.

1. Accidental medical treatment: The reimbursement rate for medical expenses incurred by insured persons of less than 6,000 yuan (including outpatient and emergency treatment) is 70%; the reimbursement rate for inpatient hospitalization of more than 6,000 yuan is 80%; and the maximum payment limit is 350,000 yuan.

2. Accidental Disability: If you are physically disabled as a result of an accident, you will be given a one-time subsidy depending on the circumstances. The specific standards are: 20,000 yuan if the disability grade of the accident is 4; 20,000 yuan if the disability grade of the accident is 3; 30,000 yuan if the accident is 2; 30,000 yuan if the accident is 1; 10,000 yuan if the accident is 1.

3. Accidental death: Participants in the accidental death of injury, since January 1, 2022, in accordance with the 2020 annual average monthly salary of the city's workers two times the standard, the legal heirs of a one-time payment.

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1. Outpatient assistance: medical assistance objects in the city medical assistance first-class fixed-point medical institutions and community health service institutions, has been carried out to abolish the drug markup and rationalize the price of medical services second-class fixed-point medical institutions outpatient medical treatment, by the basic medical insurance. After reimbursement, outpatient medical assistance will be provided. The standard of assistance is: 50% of the individual out-of-pocket expenses within the scope of the policy, the maximum amount of assistance for special hardship cases is not more than 500 yuan per year, and the maximum amount of assistance for other assistance recipients is not more than 200 yuan per year.

2. Hospitalization (including outpatient specific diseases) assistance: medical assistance in the city medical assistance designated medical institutions hospitalization (including outpatient specific diseases) during the treatment of medical expenses incurred in accordance with the basic medical insurance drug directory, diagnostic and therapeutic items directory and the medical service facilities directory, in the basic medical insurance, the major disease insurance reimbursement policy within the scope of the part of the individual burden of the assistance standard for the basic medical insurance, the major disease insurance reimbursement. The standard of assistance for the part of personal burden within the basic medical insurance and major disease insurance is 60% for the part below 20,000 yuan, and 80% for the part above 20,000 yuan (inclusive). Among them, enjoying the low income, special needy dependent persons, low-income families with severe disabilities increased by 5 percentage points, medical assistance for orphans, HIV-infected children, children in difficult circumstances, the fact that no one to support the children's personal burden of more than 20,000 yuan (including) increased by 5 percentage points.

3. Medical aid for serious illnesses: medical aid recipients, persons with severe disabilities and those entitled to regular pension benefits will be given assistance for medical expenses incurred during the year as a result of hospitalization or the treatment of outpatient specific illnesses, and after being reimbursed by the basic medical insurance, major illness insurance and hospitalization (including outpatient specific illnesses) medical aid, the part of the individual's personal burden will be 20,000 yuan (inclusive). Above the medical expenses for relief, relief ratio of 50%, once a year, the maximum amount of assistance does not exceed 100,000 yuan.

1. For the portion of the starting standard up to 5,500 yuan, the reimbursement rate in the first, second and third-level hospitals will be 75%, 65% and 55%, respectively;

2. For the portion of the reimbursement rate exceeding 5,500 yuan up to less than 9,000 yuan the reimbursement rate will be unified at all levels of hospitals to be 55%.

3. The reimbursement rate for outpatient visits to contracted service organizations is increased by 5 percentage points, the cap line is increased by 200 yuan, and the organization is given a tilted reimbursement policy of 40 yuan for contracted services.

1222 years of active staff, less than 70 years of age and retirees over 70 years of age of outpatient (emergency) clinic starting standard continues to be 800 yuan, 700 yuan and 650 yuan;

2 less than 70 years of age and retirees over 70 years of age of outpatient (emergency) clinic starting standard, respectively, compared with the active staff to reduce 100 yuan and 150 yuan.

About the medical insurance reimbursement