Proportion of medical insurance reimbursement for urban and rural residents in Fuzhou

The proportion of medical insurance reimbursement for urban and rural residents in Fuzhou is different due to different medical expenses and different treatment methods. The reimbursement rate for general outpatient service is 50%, and the maximum payment limit is 800 yuan per year. This means that the insured person goes to the designated hospital for medical treatment within one year, and the medical expenses incurred within the scope of the policy are reimbursed by the basic medical insurance according to regulations. Outpatient special diseases, the insured in the designated medical institutions with accreditation registration, can enjoy the treatment of outpatient special diseases, according to the provisions of the basic medical insurance reimbursement. The specific reimbursement ratio and qifubiaozhun vary according to different diseases. The maximum annual payment limit for hospitalization expenses is 6.5438+0.2 million yuan.

Different levels of hospitals have different minimum payment standards and reimbursement rates. For example, the top three hospitals, starting from 800 yuan, have a reimbursement rate of 55%; In community health service centers and township hospitals, the threshold is 150 yuan or 300 yuan, and the reimbursement rate is 92% or 82%. It is worth mentioning that from 20 19 10, Fuzhou raised the standard of government subsidies for medical insurance for urban and rural residents from 5 10 yuan per person per year to 550 yuan per person per year. At the same time, from August 20 19 1 day, the deductible line of medical insurance for serious illness insurance for urban and rural residents was reduced from 30,000 yuan to 27,000 yuan, and the reimbursement rate within the policy scope was increased from 50% to 60%.

To sum up, the proportion of medical insurance reimbursement for urban and rural residents in Fuzhou varies according to medical expenses and treatment methods. When enjoying medical insurance benefits, it is recommended that the insured carefully understand the relevant laws and policies to ensure that their rights and interests are protected.

Legal basis:

Regulations of People's Republic of China (PRC) Municipality on Basic Medical Insurance for Urban Workers

first

In order to ensure the basic medical care for urban workers and make rational use of medical resources, these regulations are formulated in accordance with the relevant provisions of the state and the actual situation of this province.

Article 7

The basic medical insurance premium is paid jointly by the employer and the employees. Among them, the employer pays 5%-7% of the total monthly salary of its employees, and the rate of employees paying basic medical insurance premium is not less than 2% of their total monthly salary.