The standard of hospitalization reimbursement is related to the level of the hospital where the insured person is located. If you live in a tertiary hospital, the employee pays 15%, that is, 85% of the reimbursement, from the threshold to 30,000 yuan. The expenses of 30,000-40,000 yuan shall be paid by employees themselves 10%, and 90% shall be reimbursed;
If the expenses exceed 40,000 yuan to the maximum payment limit, 95% can be reimbursed, and employees only need to pay 5%.
Retirees pay 60% of the on-the-job employees, but all below the minimum threshold are paid by individuals. The basic medical insurance for employees does not pay for medical treatment items that are mainly non-clinically necessary, uncertain in effect and in need of medical services.
Including service items such as registration fees, non-disease treatment items such as beauty, treatment equipment and medical materials hearing AIDS, treatment items such as magnetic therapy and other categories such as infertility treatment.
Reimbursement conditions:
The insured person participates in the basic medical insurance in this city and does not interrupt the payment of medical insurance premiums. Meet the following conditions:
1, the applicant has gone through the insurance formalities and paid the medical insurance premium in full;
2, the insured medical expenses incurred in medical institutions, pay cash in advance, and save the relevant documents and materials.
Note: The reimbursement conditions vary slightly from place to place. Please consult the local medical insurance bureau/social security bureau for details.
And we should know that not all outpatient or surgical expenses are covered by medical insurance. Only those who fall within the scope of medical insurance and reach the deductible line can be reimbursed.