Shanxi new crown hospitalization reimbursement latest policy

Linyi County Medical Security Bureau on the new coronavirus infected patients with medical treatment protection issued a circular, in order to effectively do a good job of the new coronavirus patients with medical treatment protection, and effectively safeguard the people's life safety and health, the cost of medical expenses can be included in the scope of medical insurance reimbursement, the relevant matters are now notified as follows:

First, access to health care institutions

new coronavirus infected patients in the county-level public hospitals, township health centers, Village health centers, community health centers and other health insurance designated hospital outpatient, hospitalization into the scope of health insurance reimbursement, with social security cards, electronic health insurance vouchers or ID cards can be reimbursed for the relevant procedures.

Second, the outpatient reimbursement policy

urban and rural residents in the primary health insurance designated medical institutions (community health centers, service stations, township health centers, village health clinics), 60% reimbursement of Category A items, 50% reimbursement of Category B items. In county-level public hospitals (County People's Hospital, Hospital of Traditional Chinese Medicine, Second People's Hospital, Maternal and Child Hospital, Eye Hospital) and Linyi Tongde Hospital, 55% of Category A items are reimbursed and 45% of Category B items are reimbursed.

The maximum reimbursement is 50 yuan per person per day per visit, 230 yuan in 2022 and 250 yuan in 2023.

Urban workers (including retirees) in the three types of designated medical institutions (community health centers, service stations, township health centers, village health offices), two types of designated medical institutions (county people's hospitals, hospitals of traditional Chinese medicine, the second people's hospitals, maternity hospitals, ophthalmology hospitals, LinYi TongDe hospitals), one type of designated medical institutions (such as: the city center hospitals) outpatient clinic, the starting standard for the outpatient clinic, respectively, 30 yuan / times, 50 yuan/times, 80 yuan/times, and the reimbursement rate of medical insurance is 50%, 55%, 60% respectively, and the reimbursement rate of the same level of medical institutions for retirees is 5 percentage points higher than that of active employees. In a natural year, the annual maximum reimbursement for outpatient coordination for active employees is 1800 yuan, and the annual maximum reimbursement for retirees is 2000 yuan (the general outpatient coordination system of the Employees' Basic Medical Insurance will be implemented from January 1, 2023 onwards).

Third, hospitalization reimbursement policy

New coronavirus infected people hospitalized during the medical expenses incurred, urban and rural residents in township health centers 100 yuan threshold reimbursement of 85%, the second level of hospitals 400 yuan threshold reimbursement of 75%, private health care institutions 500 yuan threshold reimbursement of 70%; urban workers in the township health centers 200 yuan threshold reimbursement of 90%, second level of hospitals 400 yuan threshold reimbursement of 85%.