2023 what is the latest policy of employee health insurance

Employee health insurance policy is very need to pay attention to, many people for employee health insurance what new policy and pay close attention to, the next I organized for you to collect the "employee health insurance" of the latest policy, welcome to read. The latest policy of the employee health insurance is mainly in the reimbursement ratio.... To learn more about what is the latest policy of employee health insurance, follow along.

The latest policy of employee health insurance

The latest policy of employee health insurance is mainly in the reimbursement ratio, the scope of the different, together to understand it.

1, outpatient reimbursement ratio

On the health insurance, if it is a working employee, to the hospital outpatient, emergency room visit, more than 2,000 yuan of medical expenses can be reimbursed, the reimbursement rate is 50%. If you are a retiree under the age of 70, you can be reimbursed for expenses over 1,300 yuan, and the reimbursement rate is 70%. In the case of retirees over 70 years of age, expenses over $1,300 can be reimbursed at a rate of 80%. And no matter which category of people, the maximum limit of outpatient and emergency large medical expenses paid is 20,000 yuan.

For example, if an active employee spends 2,500 yuan on an outpatient visit, the 500 yuan portion can be reimbursed at 50%, which is 250 yuan.

2. Hospitalization reimbursement rate

At present, the starting amount is 1300 RMB for the first time in a year when using the basic medical insurance to pay, no matter whether it is an active employee or a retiree. And the second and subsequent hospitalization medical expenses, the starting standard is determined by 50%, which is 650 yuan. And the maximum amount of payment from the basic medical insurance pool fund (for hospitalization expenses) in a year is currently 70,000 yuan.

(1) hospitalization starting standard

tertiary hospitals including more than three levels: 700 yuan within a year of multiple hospitalizations in the order of 500 yuan, 400 yuan, 300 yuan;

secondary specialized hospitals including two levels: 600 yuan within a year of multiple hospitalizations in the order of 400 yuan, 300 yuan, 200 yuan;

primary hospitals including the following: 500 yuan within a year of multiple hospitalizations in the order of 300 yuan, 200 yuan, 100 yuan

The first level of hospitals including the following: 500 yuan for multiple hospitalizations within one year, in order of 300 yuan, 200 yuan, 100 yuan.

Below the maximum payment limit above the starting line, Category A and general medical fees for active employees pay 85%;

retirees pay: 90%. Class B drugs pay 75% high precision pay 70%;

Employee health insurance chronic and special diseases, major diseases, the starting standard is 700 yuan in the year. Category A and general diagnosis and treatment paid 80%, Category B is 75% highly sophisticated 70%.

3, urban workers health insurance reimbursement scope

outpatient, emergency medical expenses;

(1) to the designated retail pharmacy drug costs;

(2) emergency rescue stay and income inpatient treatment, its hospitalization before the stay within 7 days of the medical costs;

(3) malignant tumors radiation therapy and chemotherapy, renal dialysis, kidney transplantation, anti-rejection medication taken after the outpatient medical costs. (3) Outpatient medical expenses for radiation therapy and chemotherapy for malignant tumors, kidney dialysis, and antirejection medication after kidney transplant.

The following items are not covered by the urban workers' medical insurance:

(1) service items

(1) registration fees, out-of-hospital consultation fees, and costs of medical records;

(2) consultation fees, expedited fees for examinations and treatments, surcharges for named surgeries, fees for high quality services, and special medical services such as hiring special nurses.

(B) non-disease treatment programs

(1) a variety of beauty, fitness and non-functional cosmetic, orthopedic surgery, etc.;

(2) a variety of weight loss, fat, height projects;

(3) a variety of physical examination;

(4) a variety of preventive, health care diagnostic and treatment programs;

(5) a variety of medical consultations, medical appraisal.

(1) the application of positron emission tomography (PET), electron-beam cT, ophthalmic excimer laser therapeutic instrument and other large-scale medical equipment for the examination and treatment of the project;

(2) eyeglasses, dental prostheses, eye prostheses, prosthetic limbs, hearing aids and other rehabilitative appliances;

(3) a variety of health care for their own use, massage, check and treatment Instruments;

(4) the provincial price departments can not be charged separately for disposable medical.

(D) therapeutic projects category

(1) all types of organ or tissue transplantation of organ or tissue source;

(2) in addition to kidney, heart valve, cornea skin, blood vessels, bone, bone marrow transplantation of other organs or tissue transplantation;

(3) myopic orthopedic surgery;

(4) qigong therapy, music therapy, health care of nutritional therapy, magnetic therapy and other complementary therapeutic projects.

(E) other

(1) a variety of infertility (pregnancy), sexual dysfunction diagnosis and treatment program;

(2) a variety of scientific research, clinical verification of the diagnosis and treatment program.

Today is a society of law, many things closely related to life can not be separated from the law, so we should have some knowledge of some of the usual legal knowledge.