Lassa medical insurance reimbursement ratio, Lassa residence medical insurance reimbursement process, employee supplementary medical insurance contribution ratio, Lassa individual medical insurance payment ratio base, Lassa fixed-point medical institutions and pharmacies, rural cooperative medical care.
Participation in medical reimbursement requires the insured employee to apply for outpatient special disease identification. The employee in the designated medical institutions to receive "Lhasa City urban workers basic medical insurance outpatient special disease recognition approval form" fill in the relevant content, the receiving doctor to fill in the diagnosis and treatment advice, and by the designated hospital attending physician to confirm, with the relevant examination, laboratory tests to the unit of the political work personnel department to verify the signature by the unit to the medical insurance agency for approval. After the approval, the insured employee will go to the designated medical institution with the approval form, medical insurance card and medical insurance card to enjoy the treatment of outpatient special diseases. The approved treatment period for each outpatient special disease is 180 days, and the dosage of medication does not exceed 15 days per visit. For medical expenses that meet the criteria for the 20 outpatient special diseases and are in line with the catalog, there is no starting line, and the medical insurance fund pays 80% of the medical expenses to the insured employees.
Additionally, the basic medical insurance will pay for the medical expenses incurred in the designated optional designated medical institutions and designated retail pharmacies, as long as they are in line with the scope of the basic medical insurance drug catalog, the scope of the basic medical insurance diagnostic and treatment items, and the scope of the standards of the basic medical insurance medical service facilities, in accordance with the provisions of the basic medical insurance. Among them, Class A drugs will be reimbursed in full, Class B drugs will be reimbursed after the individual pays 10% out-of-pocket first, but drugs that are not included in the drug catalog will be paid for by the individual in full. The reimbursement rate for diagnostic and therapeutic equipment and medical materials in accordance with basic medical insurance is 98%. The maximum standard for inpatient bed fee is determined according to the level of hospitals, such as 80 yuan/day for third-level hospitals, 60 yuan/day for second-level hospitals and 40 yuan/day for first-level hospitals.
But the registration fee, case book fee and other service items, beauty, non-functional cosmetic surgery and other non-disease treatment items, glasses, prosthetics and other diagnostic and treatment equipment and medical materials, myopic orthopedics and other treatment items, the treatment of infertility (pregnancy) or a variety of scientific research, clinically validated diagnostic and treatment items basic medical insurance does not pay the cost.
Lhasa Labor and Social Security Secretary Xu Haiyuan said that last year Lhasa City, 36,033 urban residents to participate in medical insurance, this year the number of residents to participate in medical insurance reached 37,091 people, two years **** financing 14,624,800 yuan, of which the individual to pay 2,798,700 yuan, the county-level financial subsidies of 1,180,300 yuan, municipal financial subsidies 3.271 million yuan, the autonomous region financial subsidies 7.438 million yuan. "At present, we have reimbursed 4.225 million yuan in hospitalized medical fees for 1,105 insured residents, whose total costs were 7.0574 million yuan, and the average reimbursement rate of the integrated fund was 60 percent."
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