Present your health insurance card directly to the hospital and you will be reimbursed.
Medicare has to differentiate between medicare and non-medicare drugs, and the reimbursement threshold varies according to the level of the hospital.
Generally, Class A drugs can enjoy full reimbursement, while Class C requires full out-of-pocket expenses, and Class B reimbursement is 80%, with a 20% out-of-pocket payment.
Hospitalization reimbursement scope:
1, medicine: auxiliary examination: EKG, X-ray fluoroscopy, filming, laboratory tests, physical therapy, acupuncture, CT, nuclear magnetic **** vibration, and other various examination fees limited to 200 yuan;
2, surgical fees (with reference to the national standard, more than 1,000 yuan reimbursement of 1,000 yuan). 60 years old and above hospitalized in the health center. Treatment and nursing fees are reimbursed at 10 yuan per day, with a limit of 200 yuan.
3. Reimbursement rates: 60% for township health centers; 40% for secondary hospitals; and 30% for tertiary hospitals.
The scope of reimbursement for major diseases:
1. All hospitalized patients who participate in cooperative medical care will be compensated for their one-time or yearly cumulative reimbursable medical expenses exceeding 5,000 yuan in segments, i.e., 65% of 5,001-10,000 yuan, and 70% of 10,001-18,000 yuan.
2. The annual limit of compensation for inpatient hospitalization and outpatient blood dialysis for uremia, outpatient radiotherapy and chemotherapy for oncology is 11,000 yuan at the town-level cooperative medical treatment.
Expanded Information:
Taking the employee health insurance as an example, the system of coordinated plus individual account is implemented, and after a certain number of consecutive years of contributions (usually 25 years, but also 20 or 15 years), retirement can be entitled to treatment without contributions.
After a three-month break in contributions, the co-ordinated account calculation of the continuous contribution period needs to be restarted, and the original contribution period is zeroed out. However, some regions also allow retroactive contributions at the time of retirement to reach the continuous contribution period, "the money in the personal account are their own, will not be zeroed out."
"For urban and rural residents' health insurance, the implementation of pay-as-you-go system, there is no personal account, and there is no talk of clearing zero." Some regions stipulate that after a certain period of time (which varies from place to place) of broken contributions, they will no longer be entitled to treatment and cannot be reimbursed, but as long as they re-pay their contributions they will be entitled to treatment in the following month.
Medicare card personal account belongs to the individual, but its fund composition in addition to personal contributions, there is also a part of the integrated fund transferred to the part, so it is necessary to strictly in accordance with the scope of the personal account to pay for the use of, shall not be arbitrarily cashed, string of exchange items. Personal accounts can only be limited to medical purposes. Chen Qiulin said, some provinces and cities to realize the health insurance account family **** Jinji, can pay for the spouse, children, parents of the medical insurance costs, limited to immediate family and spouse, can not be arbitrarily lent to others to swipe the card.
Baidu Wikipedia - medical insurance reimbursement ratio
People's Daily Online - hospitalized more than 15 days can not be reimbursed by medical insurance? Ministry of Human Resources and Social Security: there is no regulation