Medicare card general outpatient can also be reimbursed. The medical insurance is divided into two kinds of basic medical insurance and hospitalization insurance, the basic medical insurance need to pay the unit and individual medical insurance premiums, hospitalization insurance is only the unit to pay, the individual does not have to pay. The basic medical insurance has money in the medical insurance card (the part that one pays), the hospitalization insurance has no money in the medical insurance card; before the hospitalization insurance is not reimbursed if one is not hospitalized, from July 1 this year, the monthly reimbursement for general outpatient visits is 300 / yuan (maximum).
No hospitalization outpatient can be reimbursed
Two, health insurance reimbursement notes are
1, admission or discharge must be held health insurance IC card to the designated health insurance management window of each medical insurance institutions for hospital registration procedures. When you are hospitalized, you will have to pay a deposit in advance for the medical fees, and you will have to pay more or less after you are discharged from the hospital.
2, different regions, the starting line of medical insurance are different, such as Beijing outpatient starting line is 1800 yuan a year, hospitalization starting line of 1300 yuan a year.
3, only in the medical insurance catalog of drugs and therapeutic items cost, can be reimbursed medical insurance. Category A is fully reimbursed, Category B is only reimbursed 80% or 90%, and Category C is not reimbursed.
4, health insurance reimbursement is also limited, a person's maximum annual insurance has a limit, different regions have different policies.
Legal basis:
"Regulations of the People's Republic of China on Basic Medical Insurance for Urban Workers"
Article 27 The personnel of the employing units who pay the basic medical insurance premiums in accordance with these regulations shall enjoy the basic medical insurance treatment.
Article 28 Individual accounts shall be used to pay for medical expenses beyond the scope of payment by the integrated fund; any shortfall in payment by the individual account shall be borne by the individual himself/herself.
Article 29 The medical fees for hospitalization for serious diseases shall be paid as follows:
(1) The starting standard shall be controlled in principle at 9%-11% of the average annual social wage of the employees in cities, counties and autonomous counties in the previous year.
(b) The maximum payment limit is in principle controlled at 3-5 times of the average annual social wage of employees in cities, counties and autonomous counties in the previous year.
(3) Medical fees above the threshold and below the maximum payment limit are mainly paid by the integrated fund, with a certain percentage borne by individuals. The proportion of medical expenses borne by retirees is appropriately taken care of. The scope of serious diseases, the specific criteria for the starting standard and the maximum payment limit, and the proportion of medical expenses above the starting standard and below the maximum payment limit to be shared by the provincial people's government shall be determined by the provincial people's government.