Proportion of medical insurance reimbursement in Yulin City in 2022

Qifubiaozhun and reimbursement ratio of basic medical insurance for urban residents are determined according to the categories of insured persons. First, students and children. In a settlement year, medical expenses below RMB 6,543,800,000+800,000 were incurred, which were within the scope of reimbursement. The threshold of tertiary hospitals is 500 yuan, and the reimbursement rate is 55%. The threshold of secondary hospitals is 300 yuan, and the reimbursement rate is 60%. There is no threshold for primary hospitals, and the reimbursement rate is 65%. The second is the elderly over 70 years old. In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold of tertiary hospitals is 500 yuan, and the reimbursement rate is 50%; The threshold of secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no threshold for primary hospitals, and the reimbursement rate is 65%. Third, other urban residents. In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold of tertiary hospitals is 500 yuan, and the reimbursement rate is 50%. The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%. There is no threshold for primary hospitals, and the reimbursement rate is 60%. Urban residents hospitalized for more than two times in a settlement year, starting from the second hospitalization, no longer charge Qifubiaozhun fees. Transfer or hospitalization for more than two times, make up the difference of Qifubiaozhun in accordance with the provisions of transfer or hospitalization again.

(2) After getting medical insurance, if they are on-the-job employees, they can only reimburse more than 2,000 yuan for medical expenses after seeing a doctor in the emergency department of the hospital, and the reimbursement ratio is 50%. For retirees under the age of 70, the expenses above 1300 yuan can be reimbursed, and the reimbursement rate is 70%. For retirees over 70 years old, the reimbursement rate of expenses above 1300 yuan (deleted) is 80%. No matter what kind of people, the maximum payment limit for outpatient and emergency medical expenses is 20 thousand yuan. There is no deductible for the general outpatient expenses incurred by the insured workers in the basic medical institutions that implement the national basic drug system; In other primary medical institutions, the minimum payment standard was reduced from 40 yuan to 30 yuan. The reimbursement limit for the first-class general outpatient service was raised from 60 yuan to 80 yuan; The second payment was made in 200 yuan. The contribution ratio of medical insurance for enterprise employees is: 8% of the unit contribution base and 2% of the individual contribution base of employees. However, it should be reminded that the base of employee medical insurance payment in different provinces and cities is different. Taking Guangzhou as an example, in 20 17424, the base of medical insurance payment for employees in Guangzhou was adjusted from 1856 1 yuan, and the lower limit was adjusted from 3485 yuan to 37 12 yuan. In addition, the payment base for flexible employees to participate in social medical insurance for employees is 60% of the average monthly salary of employees in this city last year, that is, 37 12 yuan.

Legal basis: Article 25 of the Social Insurance Law of People's Republic of China (PRC), the state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.