2. The responsibility outside medical insurance can guarantee the hospitalization expenses outside the basic medical insurance, including the medical expenses outside medical insurance such as compliance treatment and inspection in the designated medical institutions according to regulations. After deducting the deductible of 20,000 for healthy people, 70% can be reimbursed, and after deducting the deductible of 40,000 for people with previous diseases, 35% can be reimbursed;
3.25 kinds of domestic specialty drugs and 75 kinds of overseas specialty drugs are guaranteed. Healthy people can be reimbursed 60% after deducting the deductible of 20 thousand, and those with previous diseases can be reimbursed 30% after deducting the deductible of 40 thousand.
"Beijing Pratt & Whitney Health Insurance" is jointly guided by Beijing Medical Insurance Bureau and Beijing Local Financial Supervision Administration, and supervised by Beijing Supervision Bureau of Bank of China Insurance Regulatory Commission. It is the only customized commercial medical insurance project in Beijing and a useful supplement to the basic medical insurance in Beijing. In order to let more Beijing medical insurance participants know about this measure to benefit the people, enhance the family's ability to resist the risk of high medical expenses, and realize the economic benefits of families with personal medical insurance accounts, from now on, Beijing urban workers' medical insurance participants can not only use the balance of the special passbook for medical insurance personal accounts to pay premiums directly, but also use their personal account balances to insure their parents, children, spouses and other immediate family members, and one person can pay for the family.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.
Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Seventy-second social insurance agencies should be established in the overall planning area. According to the needs of the work, with the approval of the local social insurance administrative department and the organization management organ, the social insurance agency may set up branches and service outlets in this overall planning area. The personnel expenses of social insurance agencies and the basic operating expenses and management expenses incurred in handling social insurance shall be guaranteed by the finance at the same level in accordance with state regulations.
Article 73 Social insurance agencies shall establish and improve business, financial, safety and risk management systems. Social insurance agencies shall pay social insurance benefits in full and on time.