Medical insurance can be divided into employee medical insurance, urban medical insurance and rural medical insurance according to different insured objects, while university medical insurance has been included in urban medical insurance coverage. College students pay their own medical insurance, and the medical expenses when they are sick are reimbursed by medical insurance. that
Medical insurance reimbursement for college students
What's the ratio? Bian Xiao will answer you right away.
First, the proportion of college students' medical insurance reimbursement
Medical expenses incurred by insured college students due to diseases above Qifubiaozhun (300 yuan) shall be compensated by stages according to the following standards, with the maximum annual compensation limit of 30,000 yuan.
(a) in accordance with the provisions of the outpatient medical expenses, according to the following proportion of reimbursement, the rest of the individual pays:
1, if the medical expenses are insufficient 1000 yuan, 35% will be reimbursed;
2, medical expenses in 1000 yuan (including 1000 yuan) above, less than 5000 yuan, 45% reimbursement;
3, medical expenses in more than 5000 yuan (including 5000 yuan), less than 10000 yuan, 55% reimbursement;
4, medical expenses in 1 ten thousand yuan (including 1 ten thousand yuan) above, reimbursement of 65%.
(two) in accordance with the provisions of the medical expenses incurred in hospitalization, according to the following proportion to be reimbursed, the rest of the individual pays, and the medical expenses of multiple hospitalizations during the year are calculated:
1, medical expenses 10000 yuan, medical treatment in tertiary, secondary and primary medical institutions, with reimbursement rates of 55%, 65% and 75% respectively;
2. The medical expenses are above 10000 yuan (including 10000 yuan) and within 20000 yuan, and the reimbursement rates in tertiary, secondary and primary medical institutions are 60%, 70% and 80% respectively;
3, medical expenses in more than 20000 yuan (including 20000 yuan), in the tertiary, secondary and primary medical institutions, the reimbursement rate is 65%, 75% and 85% respectively.
Second, the scope of medical insurance reimbursement for college students
1. There is no disease limitation 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.
2. Maternity expenses shall be subsidized in a fixed amount. 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. The scope of chronic diseases includes coronary atherosclerotic heart disease (excluding occult type), chronic pulmonary heart disease, essential hypertension (above stage II), cerebrovascular disease recovery period, 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 2000 yuan.
4. The scope of accidental injuries in outpatient service includes 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 above is the reimbursement ratio and scope of college students' medical insurance. The minimum compensation for medical insurance for college students is 300 yuan, which means that medical expenses insurance below 300 yuan will not be compensated, and medical expenses above 300 yuan will be compensated cumulatively according to a certain proportion, with the highest reimbursement rate of 85%. The reimbursement rates of tertiary, secondary and primary hospitals are different, and hospitalization can be reimbursed more than outpatient treatment.