1, general outpatient co-ordination

The medical insurance fund subsidizes outpatient medical expenses that exceed Qifubiaozhun but meet the maximum limit in a natural year. See the following table for specific standards:

2, outpatient large medical expenses subsidies

In an insurance year, the general outpatient medical expenses of the employees' basic medical insurance insured in designated medical institutions in medical insurance coverage (except those included in the scope of serious illness insurance) shall be paid by the employees' basic medical insurance fund in accordance with the regulations, and the individual pays more than the part.

If it exceeds 6000 yuan, it will be subsidized by the employee medical assistance fund according to the proportion of 50%, and the maximum subsidy limit is 654.38+10,000 yuan.

The enjoyment conditions and the scope of medical expenses of large medical expenses subsidies for workers' outpatient clinics are consistent with those of ordinary outpatient clinics with basic medical insurance for workers.

3, outpatient chronic disease drug subsidies

When the insured uses the drugs in the catalogue of outpatient chronic disease drug subsidies in the designated units that meet the requirements, the expenses that meet the requirements of medical insurance can enjoy subsidies.

Outpatient chronic disease drug subsidies are used on a monthly basis, and the balance of the current month can be carried forward to the next month. The accumulated amount is valid in the current year and recalculated in the following year.

4, outpatient specific diagnosis and treatment project subsidies

You can enjoy the treatment of specific outpatient treatment items directly by swiping your card at designated medical institutions without going through other formalities.

5, outpatient specific disease subsidies

Outpatient treatment of the following diseases, in line with the provisions of the medical expenses can enjoy subsidies in accordance with the provisions. Among them, severe mental illness and hepatitis C can only enjoy subsidies if they use drugs within the prescribed scope in outpatient clinics.

6, outpatient illness allowance

Within a year, in the selected designated medical institutions, the following serious illness outpatient treatment, in line with the provisions of the outpatient medical expenses can enjoy subsidies.

Second, the scope and proportion of hospitalization reimbursement

Within a settlement year, the medical expenses incurred by the insured in hospital that meet the requirements exceed the Qifubiaozhun, and shall be paid by the medical insurance co-ordination (rescue) fund in proportion. Medical treatment in the city requires a social security card to swipe the card for medical treatment.

Emotional mental disorders (mania, manic depression), the insured hospitalization medical expenses, in the original individual pays the proportion of the period are halved.