Proportion of medical insurance reimbursement in icu ward

Legal analysis: ICU ward expenses can be reimbursed by medical insurance, but generally only about 40%, and the drugs commonly used in ICU are expensive new drugs or imported drugs, so medical insurance is not reimbursed, so the part of medical insurance reimbursement is very small. If the patient gets better, he can be transferred to the general ward.

The reimbursement rate of ICU medical insurance is 60%, 55% and 50%.

The treatment expenses incurred by insured residents in hospitalization in different types of designated medical institutions that meet the requirements of medical promotion shall be paid in the following proportion if the minimum payment limit is above Qifubiaozhun:

1, a class of designated medical institutions (including community health service institutions), with 60% paid by the overall fund and 40% borne by individuals;

2, two types of designated medical institutions, the overall fund to pay 55%, individuals bear 45%;

3, three types of designated medical institutions, the overall fund to pay 50%, individuals pay 50%;

4. The annual coverage of residents' medical insurance is calculated according to the natural year. In a natural year, the cumulative maximum payment limit of the overall fund is 25,000 yuan (including the prescribed disease expenses for hospitalization and outpatient service).

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured are paid by the basic medical insurance fund and directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.