Maximum reimbursement amount of medical insurance for urban residents
Outpatient reimbursement: 2,000 yuan
Reimbursement for hospitalization: 6,543,800 yuan+7,000 yuan
Maximum reimbursement amount of medical insurance for urban workers
Outpatient reimbursement: 20,000 yuan
Hospitalization reimbursement: 300,000 yuan
Extended data
Reimbursement scope
First, the basic insurance does not pay the cost of the scope of medical treatment projects.
(1) service items
1, registration fee, out-of-hospital consultation fee, medical record fee, etc.
2. Special medical services such as visiting fees, urgent fees for examination and treatment (except for emergency), surcharge for roll call operation, high quality and good price, and special care by oneself.
(2) Non-disease treatment projects
1, various beauty (life beauty, medical beauty) bodybuilding projects and disorderly non-functional plastic surgery, orthopedic surgery, etc. ;
2, a variety of weight loss, weight gain, increase the project.
3. Various health checks.
4, all kinds of prevention and health care projects.
5, tooth deformity, tooth porcelain.
6, all kinds of medical consultation (excluding psychiatric consultation), medical appraisal.
(3) Diagnostic equipment and medical materials.
1, a project for examination and treatment with large medical equipment such as positron emission tomography, electron beam CT and ophthalmic excimer laser therapeutic apparatus.
2, glasses, dentures, artificial eyes, artificial limbs, hearing AIDS and other rehabilitation equipment.
3, all kinds of self-use health care, massage, rehabilitation and treatment equipment.
(4) Treatment items
1, the organ source or tissue source of various organ transplants or tissue transplants;
2. Transplantation of organs or tissues other than kidneys, heart valves, corneas, skin, blood vessels, bones and bone marrow.
3. Orthopedic surgery for myopia
4, Qigong therapy, music therapy, health nutrition therapy, magnetic therapy and other auxiliary treatment projects.
(5) Others
1, various infertility (pregnancy), sexual dysfunction diagnosis and treatment projects
2, all kinds of scientific research, clinical verification of diagnosis and treatment projects.
Two, the basic medical insurance to pay part of the cost of diagnosis and treatment project scope
(a) diagnosis and treatment equipment and medical materials
1, using X-ray computed tomography (CT), stereotactic radiotherapy device (γ knife, χ knife), cardiac and angiographic X-ray machine (including digital subtraction equipment), magnetic resonance imaging device (MEI), single photon emission computerized scanning device (SPECT), color Doppler instrument, medical linear accelerator and other large medical equipment.
2. Extracorporeal shock wave lithotripsy and hyperbaric oxygen therapy
3. Pacemakers, artificial joints, intraocular lenses, artificial organs replaced in vascular stents and materials implanted in the body.
4, the provisions of the provincial price department can be charged separately for disposable medical materials.
(2) Treatment items
1, hemodialysis, peritoneal dialysis
2, kidney, heart valve, cornea, skin, blood vessels, bones, bone marrow transplantation
3. Cardiac laser drilling, anti-tumor cellular immunotherapy and fast neutron therapy projects.
(three) the inspection and treatment items and medical materials of medical instruments and equipment with a single cost of more than 400 yuan.
Reference source: Baidu Encyclopedia: Employee Medical Insurance