Specifically, you want to know how to reimburse the social security card to see the doctor, the specific reimbursement rate must be referred to.
First, the use of special medical materials or the use of disposable medical materials with a unit price of more than 1,000 yuan, as well as for the installation and replacement of artificial organs, the basic medical insurance co-ordination fund will pay 90% of the price of the domestic universal;
Second, chronic renal failure in the outpatient clinic to do dialysis, the outpatient clinic after organ transplantation with anti-rejection drugs, malignant tumors in the outpatient clinic chemotherapy, radiotherapy, interventional therapy or nuclear therapy The basic medical expenses for outpatient chemotherapy, radiotherapy, interventional therapy or nuclide therapy of malignant tumors are paid 90% by the basic medical insurance co-ordination fund;
Thirdly, outpatient special examination and treatment expenses are paid 80% by the basic medical insurance co-ordination fund, and 20% by the individual;
Fourthly, the continuous payment of premiums is linked with the reimbursement rate, and the reimbursement rate is increased to 71% after the participants have participated in the insurance for 2 years, and the reimbursement rate is increased to 72% after they have participated in the insurance for 4 years. after which the reimbursement rate increases to 72%, and so on.
It should be reminded that the reimbursement rate of the social security card is not the same in different cities, which is mainly related to the local medical insurance treatment, it is recommended that you can call the social security telephone 12333 consultation, or to the local social security bureau!
Social security card hospitalization reimbursement notes:
1. Different hospitals have different health insurance reimbursement ratios
If a person uses 10,000 yuan in the hospital, if it is in the first level of hospitalization, then subtract 500 yuan; if it is in the second level of hospitalization, then subtract 1,000 yuan; if it is the third level of hospitalization, then subtract 2,000 yuan; and after that, subtract 2,000 yuan; and if it is the third level of hospitalization, then subtract 2,000 yuan; then subtract 2,000 yuan. If you are hospitalized in a tertiary hospital, you will first subtract 2,000 yuan; after that, you will exclude "non-medicare medication costs" and "other non-medicare costs", leaving 80% for active employees, and 50% for retired, unemployed and unemployable people.
Note: Health insurance reimbursement is only insured for Class A drugs that are used for medical insurance, Class B is not reimbursable for non-medical insurance.
2. Hospitalization reimbursement rate for active employees
Medicare hospitalization, the total cost of hospitalization, in addition to the out-of-pocket portion of the first 10% of Category B costs out of pocket, more than the threshold fee of the hospital's health care insurance part of the payment rate, to enjoy the co-ordination of the proportion of the payment. The hospital's threshold fee is different for different levels of hospitals, and so is the percentage of the total payment. The percentage of employee health insurance is more than 80% (82%/84%/87% in Wuhan), and the percentage of resident health insurance is about 70% (80%/65%/50% in Wuhan).
So it seems that the proportion of medical insurance hospitalization out of their own pockets, it is not easy to say, out-of-pocket part of all out of their own pockets, the threshold fee all out of their own pockets, the cost of Category B first out of their own pockets 10%, and then with the cost of Category A, out of their own pockets 20% or so.
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