1, Category A, the basic medical scope has been fully covered, 100% can be reimbursed.
2, Category B, the basic medical category is not fully covered, this will vary from region to region, generally need to pay for the part of the hospital invoice "price" column there is a column after the "self-care ratio" will indicate the need for personal out-of-pocket expenses. The percentage will be indicated in the column "Self-care ratio" after the "Price" column. Some may be 10%, some 5%, some 3%, some 0%.
3, category C, the basic medical care is not covered, most areas need to pay 100% of the individual. Of course, there may be some areas will be reimbursed some; specific hospital invoices can be seen on the "self-care ratio" column.
4. In short, regardless of Class A, Class B, or Class C; regardless of outpatient, or inpatient, most hospital invoices or inpatient charge details will be labeled with the "self-care ratio" of each drug, medical material, checkups, lab tests, etc.; if not, the hospital may be a "non-Medicare designated point". "The first time I've seen this, I've had to go to the hospital.
Expanded information:
1, reimbursement limit: a natural year of the general outpatient Emergency expenses incurred in a natural year in the staff accumulated more than 2,000 yuan, more than 2,000 yuan of the part of the large medical mutual fund to pay 50%, the individual out of pocket 50%. For retirees, the total amount exceeds RMB 1,300 yuan, and the part of RMB 1,300 yuan or more will be paid 70% by the large medical mutual fund for those who have reached the age of 70, and 30% by the individual; for those who have reached the age of 70, 80% will be paid by the large medical mutual fund, and the individual will pay 20% out of his own pocket. The maximum payment limit is 20,000 yuan in a natural year.
2, medical management: general outpatient, emergency expenses personal cash payments, medical expenses incurred in line with the scope of the three major directories of medical insurance library, purchasing drugs should be first in the designated hospitals to issue a special prescription and stamped with the special seal of medical insurance purchasing, and then to the designated pharmacies to buy drugs.
3, the reimbursement process: a natural year cumulative more than the starting standard, the insured person will be submitted to the unit or social security office documents, the unit or social security office will be entered into the enterprise version of the documents, the electronic information and documents declared to the medical insurance center. The medical insurance center will complete the audit, settlement and payment within 15 working days.
Baidu Encyclopedia-Medicare reimbursement rate