The reimbursement scope of urban residents' medical insurance includes a lot of diseases, ranging from small colds and fevers to major cancers and serious illnesses, all of which are covered; according to the current backbone of the provisions of the insured, the costs of the following items incurred by designated medical institutions and designated retail pharmacies are included in the reimbursement scope of the Urban Residents' Basic Medical Insurance Fund
1, medical costs of hospitalization treatment
2, Medical expenses incurred within 7 days prior to being admitted to an emergency clinic and transferred to hospitalization
3. Medical expenses in accordance with the provisions of outpatient special diseases for urban residents
4. Other expenses in accordance with the regulations
Expanded Information:
Reimbursement of basic medical insurance for urban residents Ratio
1. Students and children
In a settlement year, for medical expenses under 180,000 RMB that are eligible for reimbursement, the starting standard for a tertiary hospital is 500 RMB and the reimbursement ratio is 55%; the starting standard for a secondary hospital is 300 RMB and the reimbursement ratio is 60%; a primary hospital does not have a starting standard, and the reimbursement ratio is 65%
2. Elderly people over 70 years of age
In a settlement year, for medical expenses under 100,000 yuan that meet the scope of reimbursement, the starting payment standard for tertiary hospitals is 500 yuan, with a reimbursement rate of 50%; the starting payment standard for secondary hospitals is 300 yuan, with a reimbursement rate of 60%; and there is no starting standard for tertiary hospitals, with a reimbursement rate of 65%
3. Other urban residents
For medical expenses under 100,000 RMB incurred within a billing year that meet the scope of reimbursement, the starting standard for hospitalization in Level III hospitals is 500 RMB and the reimbursement rate is 50%; the starting standard for hospitalization in Level II hospitals is 300 RMB and the reimbursement rate is 55%; and for Level I hospitals, there is no starting standard and the reimbursement rate is 60%
Urban residents who are hospitalized for more than two times in a billing year shall no longer be charged the starting standard for hospitalization from the second time onwards. If a resident is hospitalized for more than two times in one billing year, he/she will no longer be charged the starting standard fee from the second hospitalization; if he/she is transferred to another hospital or hospitalized for more than two times, he/she will be compensated for the difference in accordance with the starting standard of the hospital to which he/she is transferred or re-admitted
Baidu Encyclopedia-Basic medical insurance system for urban residents
Baidu Encyclopedia-Basic medical insurance for urban residents