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1, can be: according to the local urban and rural health insurance (draft for comment) of the provisions: participants incur hospitalization medical expenses within the scope of the provisions, the establishment of a starting standard, the integrated fund will pay a certain percentage:
(1) grass-roots fixed-point medical and health care institutions (township health centers, community health service institutions) starting standard of 100 yuan, the reimbursement rate of 85%;
(2) The starting payment standard of first-level designated medical institutions is 500 yuan, and the reimbursement rate is 75%; the starting payment standard of second-level designated medical institutions is 800 yuan, and the reimbursement rate is 65%; the starting payment standard of third-level designated medical institutions is 1,000 yuan, and the reimbursement rate is 55%;
(3) If a participant applies for the referral procedures according to the regulations, and is hospitalized in a designated medical institution for medical treatment in a cross-city location within the province, the starting payment standard is 1,500 yuan, and the reimbursement rate is 45%. standard is 1,500 yuan, and the reimbursement rate is 45%; for inter-provincial cross-location medical treatment hospitalized in designated medical institutions outside the province, the starting payment standard is 2,000 yuan, and the reimbursement rate is 35%.
2. Settlement standards for the handling of referral and transfer procedures not in accordance with the regulations:
(1) The insured person does not go through the referral and transfer procedures in accordance with the regulations and incurs inpatient medical fees within the scope of the regulations at the designated medical institutions outside the city on his or her own;
(2) The starting standard for medical treatment within the province and across the city is RMB 1500 yuan, with a reimbursement ratio of 25%; the starting standard for medical treatment across the province is RMB 2000 yuan, with a reimbursement ratio of 20%. 2000 yuan, reimbursement rate 20%.
3, the above "Jixi City urban and rural residents of basic medical insurance management measures" (draft).