For most families and individuals, health is one of their greatest pursuits of perfection, but people suddenly encounter accidents. Sometimes, no one knows whether it is an accident or tomorrow. At this stage, medical technology is also high, medical equipment is excellent, medical consumables and medicines are not cheap, and doctors' salaries and other miscellaneous expenses are also high. For various reasons, hospital treatment is also very expensive.
A minor illness is likely to cost tens of thousands of yuan. During the period of full medical insurance, most people participated in medical insurance. The total number of urban residents participating in medical insurance exceeded 6543.8+0.36 billion, and the number of urban and rural residents participating in medical insurance exceeded 300 million. Hospitalization can be reimbursed through cooperative medical care. For example, the hospitalization fee is 50 thousand, how much can employee medical insurance and resident medical insurance be reimbursed? I can do the math for you today.
The reimbursement ratio and threshold of cooperative medical care vary from place to place, but the calculation method of reimbursement of cooperative medical care is the same. Jiangxi is a central province, and the proportion of social and economic development and reimbursement of cooperative medical care is probably in the middle all over the country. The current medical insurance reimbursement policy in Jiangxi Province can be used as a reference. Only one item in the national medical insurance catalogue can apply for hospitalization reimbursement, and some items B and C in the TV catalogue must be paid at their own expense. Different types of hospitals have different reimbursement rates and deductible lines. If the cost is 50 thousand yuan,
Naturally, there are very few county-level hospitals or secondary hospitals that may spend this amount. In tertiary hospitals, the newly added items such as Class B and Class C are about 15%, accounting for about 7500 yuan; The proportion of secondary hospitals should be around 10%, which is 5000 yuan, which is also the general evaluation of hospitals by medical insurance departments and health and epidemic prevention departments. The proportion of expenses outside the file directory should not be too high, and it will fluctuate within this range.
The salary of the first-level hospital with medical insurance for employees is 500 yuan, and the proportion of medical insurance reimbursement is 92%. Under such circumstances, the medical insurance bill will be deducted 50,000 yuan, the salary line will be about 44,000 yuan, the 92% expenses will be reimbursed about 40,000 yuan, the second expenses will be reimbursed about 1.5 million yuan, and the starting point of the first-class hospital in 700 yuan will be about 50,000 yuan and 42,000 yuan respectively.
The second compensation can be reimbursed for about 2000 yuan, then the medical insurance of the second-class first-class hospital can be reimbursed for about 42000 yuan; The reimbursement of cooperative medical care in tertiary hospitals is about 39 thousand, and the proportion of medical insurance reimbursement is acceptable. Some civil servants can also enjoy supplementary insurance for civil servants, and the cost reaches several thousand yuan. This is happiness at the end of the universe.
For urban residents with medical insurance, the salary line of the second-class first-class hospital is 4 million yuan, the reimbursement amount of medical insurance of 50,000 yuan is about 44,600 yuan, and the reimbursement rate of medical insurance in the second-class first-class hospital is 80%, and the reimbursable expenses are about 35,000 yuan. The threshold of serious illness insurance for urban residents is13,000 yuan, but my quota has not reached the threshold, so the total reimbursement for secondary expenses is 35,000 yuan, and the starting point of tertiary hospitals is 600 yuan.
The reimbursement amount for foreign players entering medical insurance is about 42,000 yuan. If 60% of medical insurance reimbursement is in a tertiary hospital, it can be reimbursed about 25,000, reaching the starting and ending line of critical illness insurance. According to the proportion of critical illness insurance, about 2500 yuan can be reimbursed, and the total reimbursement is about 28000 yuan.
It is not difficult to see that the reimbursement rate of medical insurance for urban and rural residents is still relatively low compared with that for urban and rural employees. Even the total reimbursement of secondary hospitals can't keep up with the reimbursement ratio of medical insurance for employees in tertiary hospitals. It may be necessary to adjust this matter in the future and change the repayment difference between the two commercial insurances. Especially in Tianya, under the protection of civil servants' supplementary insurance, civil servants don't pay much for themselves, and the difference is really too big.
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