2. The starting point for Category 2 hospitals is 400, and the reimbursement rate is 70 percent.
3. The starting point for the fee for a category 1 hospital is 600, and the reimbursement rate for the health insurance is 60 percent.
4. The starting point for the fee for a category 1 hospital to be transferred to the province is 600. the reimbursement rate of the health insurance is 60 percent.
5, a class of hospitals to the province for medical treatment, the standard starting point of the fee is 600. medical insurance reimbursement rate is 55 percent.
Medicare Rehabilitation Reimbursement Standards
I. Bed Charge Reimbursement Standards
1. Second class or above designated hospitals: 120 yuan/day;
2. First class designated hospitals: 90 yuan/day;
3. The maximum payment of bed days by the Coordination Fund of the single insured patient in a medical insurance year is 90 days;
4. Special cases by Special cases can be appropriately extended the payment time limit after evaluation by professional medical institutions and examination and approval by health insurance agencies.
Second, disposable consumables reimbursement standards
1. 30% of the domestic consumables personal burden;
2. 50% of the imported materials personal burden;
3. The remaining portion of the proportion of medical insurance policy into the reimbursement, the cancellation of the maximum payment limit standard.
Specifically, rehabilitation therapy must be under the guidance of a doctor, through physical therapy, speech therapy, occupational therapy and other means of physical function rehabilitation or social adaptive rehabilitation of the patient, in order to improve their quality of life and ability to take care of themselves. If the rehabilitation treatment is in line with national and local health insurance policies, a certain percentage of the cost can be reimbursed within the scope of health insurance. It should be noted that health insurance policies and reimbursement standards may vary in different regions, and the specific reimbursement percentage and reimbursement standards need to be determined according to local health insurance policies. At the same time, rehabilitation therapy also requires the patient to bear part of the cost, the specific out-of-pocket expenses also need to be determined according to the local health insurance policy.
In summary, it is recommended to understand the local health insurance policy and reimbursement standards before receiving rehabilitation treatment, so as to choose the appropriate hospital and treatment modality and maximize the savings of medical costs.
Legal basis:
Article 28 of the Social Insurance Law of the People's Republic of China
Medical expenses that are in line with the basic medical insurance drug catalog, diagnostic and treatment items, standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.
Article 29
The portion of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.