Medical Insurance Reimbursement for College Students I. Proportion of Medical Insurance Reimbursement for College Students The hospitalization medical expenses above the minimum deductible line (300 yuan) of the insured college students due to diseases shall be compensated step by step according to the following standards, with the maximum annual compensation limit of 30,000 yuan. (1) The outpatient medical expenses that meet the requirements shall be reimbursed according to the following proportion, and the rest shall be paid by individuals themselves: 1. 35% will be reimbursed if the medical expenses are less than 1 000 yuan. 2. The medical expenses exceed 1 1,000 yuan (including 1 1,000 yuan) but are less than 5,000 yuan. Reimbursement 45%. 3. Medical expenses above 5000 yuan (including 5000 yuan) 10000 yuan shall be reimbursed by 55%. 4. 10000 yuan or more (including 10000 yuan) medical expenses shall be reimbursed by 65%. (2) The medical expenses that meet the requirements of hospitalization shall be reimbursed according to the following proportion, and the rest shall be paid by the individual. Cumulative calculation of medical expenses for multiple hospitalizations during the year: 1. The part whose medical expenses are less than 1 10,000 yuan shall be treated in tertiary, secondary and primary medical institutions. The reimbursement rates are 55%, 65% and 75% respectively. 2. The reimbursement rates of medical expenses above 10000 yuan (including10000 yuan) and below 202 10 yuan in tertiary, secondary and primary medical institutions are 60%, 70% and 80% respectively. Second, the scope of college students' medical insurance reimbursement is the first, and there is no disease limit for hospitalization reimbursement. College students must pay a certain deposit to pay the expenses that need to be borne by individuals, and refund more and make up less when checking out. College students' medical insurance is temporarily kept by the hospital medical insurance office during hospitalization. After the discharge formalities are completed, the hospital medical insurance office is responsible for filling in the overall payment form on the homepage of college students' medical insurance as required, and returning the college students' medical insurance to me. Secondly, the maternity expenses are subject to fixed subsidies. The quota standard is: normal delivery in 800 yuan, cesarean section 1600 yuan. If the birth cost is lower than the limit standard, the subsidy shall be given according to the actual expenditure; Higher than the quota standard, according to the quota standard subsidies. 3. Chronic diseases include coronary atherosclerotic heart disease (excluding occult type), chronic pulmonary heart disease, essential hypertension (above stage II), cerebrovascular disease in convalescence, decompensated cirrhosis, diabetes complicated with chronic complications, chronic glomerulonephritis and nephrotic syndrome, advanced malignant tumor, psychosis, lupus erythematosus and Parkinson's syndrome. Payment standard: outpatient chronic disease treatment will be settled annually. Within a year, if the medical expenses for outpatient treatment of chronic diseases in designated medical institutions exceed those in 350 yuan, the excess shall be paid by the overall fund and individual by 50%. In a year, the maximum amount of outpatient chronic disease medical expenses paid by the overall fund is 202 1 yuan. Fourthly, the scope of accidental injuries in outpatient service includes three diseases: fracture, joint dislocation and foreign body in respiratory tract. Payment standard: The overall fund pays 50% and the individual pays 50% of the medical expenses for outpatient treatment of the above diseases caused by accidental injuries, and the cumulative maximum payment limit of the overall fund within one year is 1 000 yuan. The most important thing for college students to clarify the scope of medical insurance reimbursement is to let themselves "know fairly well" when paying independently. They can "invest" in medical insurance projects according to their own needs and reduce unnecessary expenses. Secondly, the clear division of the scope of medical insurance reimbursement for college students has also reduced their pressure for colleges and universities. Colleges and universities don't need to uniformly ask students to pay a certain fee, which avoids the troubles of unreasonable charges and students complaining that the fees paid are too high, and also avoids the misunderstanding that students claim that they don't know where the fees went in the later period. Iii. Medical insurance reimbursement process for college students 1. Hospitalization medical expenses shall be paid by the individual first. After discharge, transfer certificate and trauma treatment shall be provided with urban residents' medical insurance card, ID card, outpatient medical record, discharge summary, total cost list (detailed list of expenses), disease diagnosis certificate, valid bill (original invoice), doctor's advice, copy of the first page of medical record and certificate issued by the school. For medical treatment in different hospitals, materials from different hospitals should be provided; In the same hospital, according to the different hospitalization time (before the expenses are written off, such as being treated in the same hospital after discharge), materials of hospitalization in different periods should also be provided; 2. Open the credit card settlement function: within three days of hospitalization, the student or student guardian or client will go to the medical department window of the service hall of the municipal medical insurance center with the student ID card, provincial social security card, hospitalization medical record, disease diagnosis certificate and certificate issued by the college; 3. Treatment of emergency expenses of non-designated medical institutions: within 3-5 working days of emergency, first contact or entrust others to register with the municipal medical insurance management center through the student medical insurance management center of our hospital, and the medical expenses will be paid in advance by myself. At the time of reimbursement, apply for reimbursement to the municipal medical insurance center according to the above reimbursement materials. (if you go to a non-medical insurance designated hospital or clinic for treatment, you will not be reimbursed. )