The proportion of hospitalization reimbursement is as follows:
The qifubiaozhun of the first-class hospital is 300 yuan, and the proportion of the overall fund payment above qifubiaozhun to below the maximum payment limit is 95%.
The Qifubiaozhun of secondary hospitals is above the Qifubiaozhun of 500 yuan, below the maximum payment limit of the overall fund, and the proportion of fund payment is 90%.
The minimum qifubiaozhun for tertiary hospitals is 1000 yuan, and the proportion of fund payment is 80% above the minimum qifubiaozhun for overall funds.
It should be pointed out that:
1, if you are hospitalized for the second time or more in a natural year, the Qifubiaozhun shall be calculated according to 50% of the stipulated hospitalization Qifubiaozhun, and if you are in the clinic due to serious illness.
Species, mental illness and AIDS hospitalization, no hospitalization Qifubiaozhun.
2. If the insured person is referred from the first-level designated medical institution to the next-level designated medical institution for hospitalization, the Qifubiaozhun for hospitalization in the next-level designated medical institution shall be cancelled; Cumulative calculation of Qifubiaozhun at transfer.
Different identities have different reimbursement rates. The medical expenses incurred by students and children in a settlement year are less than 6.5438+0.8 million yuan. The threshold of tertiary hospitals is 650 yuan, with the reimbursement rate of 50% and the upper limit of 2,000 yuan.
The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%;
There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.
At least 70 years of age and above: in a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur,
The qifubiaozhun for tertiary hospitals is 650 yuan, and the reimbursement rate is 50%, with an upper limit of 2,000 yuan;
The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%;
There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.
Other urban residents: medical expenses below 654.38+10,000 yuan in a settlement year,
The threshold for tertiary hospitals is 659 yuan, the reimbursement ratio is 50%, and the upper limit is 2,000 yuan;
The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%;
There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.
Among them, the outpatient department implements the school contract system, and the ordinary outpatient expenses incurred by students return to school with invoices and are reimbursed according to the provisions of the school outpatient contract system;
When students buy insurance, it is recommended to choose critical illness insurance, medical insurance and accident insurance. Students under the age of 20 are in the period of physical and mental growth and development, so they need to pay attention to the medical situation of minor faults to avoid leaving sequelae. Therefore, it is excellent to have medical insurance, and piecemeal medical expenses can be reimbursed; In addition, children will have more accidents in their growth stage than in other stages, so it is quite necessary to prevent accidental disability or death. Of course, as a critical illness insurance, the sooner you buy it, the more cost-effective, which is also essential.