1, the reimbursement rate of hospitalization at township level (first-class hospital) is 85%, and the deductible line is 200 yuan;
2. The reimbursement rate for hospitalization in county-level (secondary hospitals) is 70%, and the deductible line is 500 yuan;
3 municipal (tertiary hospitals) hospitalization reimbursement rate is 55%, and the deductible line is 700 yuan;
4. The reimbursement rate of provincial hospitals (tertiary hospitals) is 50%, and the deductible line is 1000.
The following materials shall be provided for reimbursement:
1, the original rural cooperation certificate, household registration book and ID card of the patient;
2, the province's unified approval form for referral and referral of the new rural cooperative medical system, migrant workers or foreign residents do not provide the approval form for referral and referral of the new rural cooperative medical system, and they need to provide village-level certificates of their work units or places of residence;
3. Diagnosis certificate;
4. Discharge certificate;
5, hospitalization medical expenses summary list;
6. Invoices of hospitalization expenses (if invoices of private medical units supervised by local tax departments are provided, the documents that the health authorities identify them as designated medical institutions of the new rural cooperative medical system shall be provided, and the official seal of the document unit shall be affixed);
7, build official seal copy of hospital medical records (including medical records home page, long-term doctor's advice, temporary doctor's advice, discharge summary).
To sum up, the medical insurance deductible refers to the basic medical insurance deductible standard, and the medical expenses below the deductible are borne by the patients themselves; If the medical expenses reach the deductible line, they shall be reimbursed according to the statutory reimbursement ratio.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be 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.