Reimbursement policy of medical insurance for employees in Jinan city

The proportion of medical expenses for employees' medical insurance hospitalization is the same as that for outpatient diseases, and it is included in the overall payment of hospitalization expenses and on-site medical expenses.

1, minimum payment standard-10000 yuan: 85% paid by medical insurance pooling fund and15% paid by individuals;

2. 1 10,000 yuan-90,000 yuan: 88% from the overall fund, 12% from individuals;

3. Reimbursement for serious illness medical insurance is 90-200,000 yuan: 90% for large medical assistance and 0/0% for individual/kloc.

Medical insurance for employees is medical insurance for urban employees. The basic medical insurance premium for medical insurance for urban employees shall be paid by the employer and individual employees.

The basic medical insurance fund consists of overall funds and individual accounts.

The basic medical insurance premiums paid by individual employees are all included in individual accounts.

Jinan medical insurance reimbursement conditions:

1, hold a card for hospitalization, register a social security card for admission, and go through the reimbursement procedures directly when you are discharged from hospital.

2. The insured who is hospitalized without a card needs to be hospitalized during the period without a card. It is necessary to bring a letter of introduction from the unit and a copy of the admission certificate to the Medical Insurance Department of the Urban Workers of the Municipal Social Security Bureau to issue a certificate without a card before going through the hospitalization formalities. When you leave the hospital, you will not settle the account for the time being, and then you will take the card to the hospital where you live to handle the expense settlement procedures.

The basic medical insurance premium paid by the employer is divided into two parts, one part is used to establish the overall fund, and the other part is included in the personal account. The proportion of individual accounts is generally about 30% of the employer's contributions, and the specific household proportion is determined by the overall planning area according to the scope of individual account contributions and the age of employees.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 23

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.