Life, we know that now we have health insurance, if you are sick and hospitalized can be reimbursed, but we also need to know that the reimbursement of certain conditions, even if they meet the conditions can not all be reported, there are certain restrictions.
A, health insurance reimbursement ceiling is how much
The first level of hospitals: reimbursement rate of 65%, the starting line of 300 yuan; second level of hospitals: in the county second level of hospitals, medical costs in the 6,000 reimbursement rate of 65%, higher than 6,000 reimbursement rate of 80%; the starting line of 400 yuan; in the city of second level of hospitals, reimbursement rate is the same, the starting line of 600 yuan.
Tertiary hospitals: in county-level tertiary hospitals, the reimbursement rate for medical expenses above 600 is 65%, and above 6,000 the reimbursement rate is 80%; the starting line is 600 yuan; in municipal-level tertiary hospitals, the reimbursement rate for medical expenses below 12,000 is 55%, and above 12,000 the reimbursement rate is 75%, and the starting line is 800 yuan; hospitals outside the city: the medical Out-of-town hospitals: 45% for medical expenses up to 20,000 RMB, 70% for expenses above 20,000 RMB, with a starting line of 1,500 RMB.
Additionally, hospitalization and drugstore purchases can be reimbursed, but the reimbursement rates and limits are restricted, and the reimbursement limits are as follows: outpatient reimbursement for township cooperative medicine is limited to a cumulative total of 5,000 yuan per year; hospitalization costs for residents over 60 years of age and nursing care are reimbursed at 10 yuan per day, with a cumulative total of up to 200 yuan each time; and surgical costs are reimbursed at a standard rate of 1,000 yuan, and more than 1,000 yuan are reimbursed at a standard rate. reimbursement will be made in accordance with the standard reimbursement rate, and reimbursement will be made in accordance with RMB 1,000 for those exceeding RMB 1,000, with a limit of RMB 1,000.
2. What are the expenses not reimbursed by medical insurance
1. Services:
Registration fee, out-of-hospital consultation fee, cost of medical records, etc.; consultation fee, expedited fee for examination and treatment, surcharge for named surgery, surcharge for named surgery, quality and premium fee, and self-employment of special nurses and other medical services for special needs.
2. Diagnostic and therapeutic equipment and medically useful materials:
Application of positron emission tomography (PET), electron beam CT, ophthalmology excimer laser treatment instrument and other large-scale medical equipment for examination and treatment programs. Eyeglasses, denture, eye prosthesis, prosthetic limbs, hearing aids and other rehabilitative devices. All kinds of self-use health care, massage, examination and treatment equipment. Provincial price departments do not charge separately for disposable medical materials.
3, the treatment program category:
various types of organ or tissue transplantation of organ or tissue source; in addition to kidney, heart valve, cornea, skin, blood vessels, bone, bone marrow transplantation; myopic orthopedics; qigong therapy, music therapy, health care of nutritional therapy, magnetic therapy and other auxiliary treatment programs.
The above is the introduction of what is the upper limit of reimbursement of medical insurance. The reimbursement will be different depending on whether you are an outpatient or an inpatient, so I hope the above is helpful
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