The reimbursement rate of urban medical insurance is: within a settlement year, medical expenses below 6,543,800 yuan that meet the scope of reimbursement occur, and the threshold for tertiary hospitals is 500 yuan, with the reimbursement rate of 50%; The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%. Urban residents hospitalized for more than two times in a settlement year, starting from the second hospitalization, no longer charge Qifubiaozhun fees. Transfer or hospitalization for more than two times, make up the difference of Qifubiaozhun in accordance with the provisions of transfer or hospitalization again.
The reimbursement ratio of Henan new rural cooperative medical system is:
1. Set deductible and compensation ratio according to hospital level. The specific compensation standards are as follows:
2. Preferential policies for deduction:
(1) If the insured person is hospitalized for the second time in a medical institution at the same level or later, the deductible can be reduced to 50% of the deductible of the medical institution at the same level;
(2)/kloc-children under 0/4 years old (including 14 years old) are hospitalized, and the compensation deductible line is reduced by 50% on the basis of the compensation deductible line stipulated by the designated medical institutions at the same level;
(3) If the participants are hospitalized in a Chinese medicine hospital at or above the county level, the compensation deductible line 100 yuan shall be reduced on the basis of the compensation deductible line of the medical institution at the same level.
For eligible insured persons who enjoy two or more deductible preferential policies, they can only enjoy one preferential policy at most. Implement hospitalization security compensation outside the province. Participants were referred to medical institutions at all levels outside the province for hospitalization. If the actual compensation ratio is too low, 35% of the total hospitalization expenses can be compensated according to the deductible.
I suggest you consult the local social security agency to get a more detailed and accurate answer. At the same time, you should also ask what kinds of drugs are reimbursed. Imported drugs used for certain diseases are not reimbursed.