1. Outpatients seek medical treatment in the binding community health center, while inpatients and outpatients are seriously ill and seek medical treatment in medical institutions.
2, belong to class A drugs and class B drugs, respectively, by the community outpatient co-ordination fund according to the proportion of 80% and 60% payment; 90% of the single diagnosis and treatment or medical materials belonging to the medical insurance catalogue shall be paid by the community outpatient co-ordination fund, but the maximum payment amount shall not exceed 120 yuan; The total outpatient medical expenses paid by the community outpatient co-ordination fund to each second-and third-level insured in a medical insurance year shall not exceed 1000 yuan.
3. The expenses incurred in the inspection and treatment of large-scale outpatient equipment shall be paid according to the highest unit price of ordinary diagnosis and treatment items 120 yuan;
4, can be bound to the social medical center settlement hospital, or by the settlement hospital referral to designated hospitals, the basic medical expenses and local supplementary medical expenses, in the hospitalization deductible part of the reimbursement ratio is:
Level 1 hospital: 85%;
Secondary hospitals: 80%;
Tertiary hospitals: 75%; Without referral to a hospital other than the settlement hospital, it will be paid according to 90% of the hospitalization payment standard of the hospital.
2. How much is Shenzhen social security every month?
Shenzhen social security, its medical insurance is divided into three grades. Depending on the level of medical insurance you choose to pay, the final social security fee is also different.
Shenzhen social security medical insurance 1 file: the first file * * 9 15. 10 yuan per month, the enterprise needs to pay 644.29 yuan per month, and the individual needs to pay 270.8 1 yuan per month;
The second file of Shenzhen social security and medical insurance: 1 * * is 585.62 yuan per month, the enterprise needs to pay 389.6 1 yuan per month, and the individual needs to pay 196.05438+0 yuan per month;
The third file of Shenzhen social security medical insurance: the first file is 566.92 yuan per month, the enterprise unit needs to pay 378.39 yuan per month, and the individual needs to pay 188.53 yuan per month.
The specific expenses paid shall be subject to the actual situation.
Legal basis:
Measures of Shenzhen Municipality on Social Medical Insurance Article 2 This Municipality implements a multi-level and multi-form social medical insurance system.
The government establishes basic medical insurance and local supplementary medical insurance.
According to the payment and corresponding treatment, the basic medical insurance is divided into one, two and three forms.