The new regulations on medical insurance reimbursement will be updated in 2022

The new policy on the reimbursement ratio of medical insurance in 2022 is as follows:

1. Medical insurance is mainly divided into employee medical insurance and resident medical insurance, and the reimbursement ratio is also different;

2. The reimbursement ratio of employee medical insurance is divided according to the level of hospitalization expenses, the reimbursement ratio between 1,300 yuan and 30,000 yuan is 85, the reimbursement ratio between 30,000 yuan and 40,000 yuan is 90, the reimbursement ratio between 40,000 yuan and 100,000 yuan is 95, and the reimbursement ratio between 100,000 yuan and 300,000 yuan is 85;

3. Residents' medical insurance is composed of the merger of urban residents' medical insurance and NCMS. The reimbursement ratio is 65 for first-class hospitals, and the starting line is 300 yuan; The reimbursement ratio of secondary hospitals below 6,000 yuan is 65, and the reimbursement ratio of more than 6,000 yuan is 80, of which the starting line of county secondary hospitals is 400 yuan, and the starting line of municipal secondary hospitals is 600 yuan.

Social Insurance Law of the People's Republic of China

Article 23.

Employees shall participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state.

Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

Legal analysisThe medical insurance reimbursement regulations are as follows: 1. The insured must go to the designated medical institutions of the basic medical insurance to seek medical treatment and purchase drugs; 2. The medical expenses incurred by the insured in the process of seeing a doctor must meet the scope and payment standards of the basic medical insurance insurance drug catalog, diagnosis and treatment items, and medical service facility standards, so as to be paid by the basic medical insurance ** according to the regulations; 3. Among the medical expenses of the insured persons who meet the scope of payment of basic medical insurance, the part of the expenses above the minimum payment standard of social medical co-ordination and below the maximum payment limit shall be paid by the social medical co-ordination ** in a unified proportion.

Legal basis"Social Insurance Law of the People's Republic of China" Article 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses for emergency and rescue, in accordance with national regulations from the basic medical insurance **.

The reimbursement rate for medical insurance is 70%. 3. The threshold of the charging standard of a first-class hospital is 600. The reimbursement rate for medical insurance is 60%.

4. For first-class hospitals to transfer to the province for medical treatment, the threshold of the charging standard is 600. The reimbursement rate for medical insurance is 60%. 5. For first-class hospitals to transfer to other provinces for medical treatment, the threshold of the charging standard is 600.

The reimbursement rate for medical insurance is 55 percent. 6. If there are multiple hospitalizations in an insurance year, the minimum payment standard for the first and second hospitalizations shall be borne by the individual. The minimum payment standard for the third and above hospitalizations shall be paid by the co-ordination**.

The maximum payout limit for an insurance annual pool** is $50,000.

Hello, the latest provisions on medical insurance reimbursement in 2022 are as follows: 1. The reimbursement ratio of medical insurance is 85%. 2. The threshold of the charging standard for second-class hospitals is 400. The reimbursement rate for medical insurance is 70%.

3. The threshold of the charging standard of a first-class hospital is 600. The reimbursement rate for medical insurance is 60%. 4. For first-class hospitals to be transferred to the province for medical treatment, the threshold of the charging standard is 600.

The reimbursement rate for medical insurance is 60%. 5. For first-class hospitals to transfer to the province for medical treatment, the threshold of the charging standard is 600. The reimbursement rate for medical insurance is 55 percent.

6. If there are multiple hospitalizations in an insurance year, the minimum payment standard for the first and second hospitalizations shall be borne by the individual. The minimum payment standard for the third and above hospitalizations shall be paid by the co-ordination**. The maximum payout limit for an insurance annual pool** is $50,000.

I photographed back within the scope of the medical insurance year. Annual outpatient large payments. Are you looking to guess that the medical insurance will also be reimbursed? Thank you

Are you seriously ill?

Outpatient visits. Haven't you already been reimbursed?

Only those who are hospitalized for surgery for serious illnesses will be reimbursed twice.

No, I mean that the reimbursement of 20,000 yuan refers to the annual medical insurance scope of 20,000, or the annual outpatient large payment cannot exceed 20,000?

refers to the annual medical insurance coverage of 20,000.

So am I more than 20,000 yuan, and I can't be reimbursed by medical insurance?

Absolutely.

You completely misunderstood.

There is no limit to the amount of medical insurance reimbursement.

My annual health insurance coverage shows. Can I still be reimbursed for outpatient treatment?

If your illness belongs.

Outpatient reimbursement coverage.

can be reimbursed.

Not all diseases can be reimbursed in the outpatient clinic.

To be eligible.

The new regulations on medical insurance reimbursement in 2022 are as follows:1. Outpatient reimbursementIf the hospital sees a doctor for a minor illness or pain, it generally incurs more outpatient expenses. Then the employee medical insurance can directly deduct the outpatient expenses from the balance of their personal accounts, and the resident medical insurance.

If the cumulative amount of outpatient expenses exceeds a certain amount this year, it can be reimbursed according to the proportion of 50%.

2. Hospitalization reimbursementIf the hospitalization expenses of the insured are above the starting line, then the reimbursement ratio of employee medical insurance can be divided into % and 82% according to the level of these types of hospitals, while the reimbursement ratio of resident medical insurance is % and 60% respectively.

and stipulated in the same calendar year.

The minimum payment standard for two or more hospitalizations is 50% of the first minimum payment standard.

3. Reimbursement conditionsThis year's standard reimbursement conditions do not include the following 5 medical expenses:

1) Those who seek medical treatment abroad, Hong Kong, Macao and Taiwan**;

2) Self-suicide or self-harm (except for mental illness.

3) Traffic, accidental injury, medical and other accidents are borne by other parties for medical compensation;

4) Injury or illness caused by one's own illegal or criminal acts;

5) Plastic surgery, infertility.

Other expenses that are not covered by medical insurance regulations, such as sexual dysfunction.

New regulations on medical insurance reimbursement in 2022: After applying for medical insurance, if you are an in-service employee, you can only be reimbursed for medical expenses of more than 2,000 yuan after going to the outpatient and emergency department of the hospital, and the reimbursement ratio is 50%. If it is a retiree under the age of 70, the expenses above 1,300 yuan can be reimbursed, and the reimbursement ratio is 70%.

If it is a retired person over the age of 70, the proportion of reimbursement for expenses above 1,300 yuan is 80%. Regardless of the type of person, the maximum amount of outpatient and emergency medical expenses paid is 20,000 yuan. There is no threshold for the payment of ordinary outpatient expenses incurred by insured employees in medical institutions that implement the national basic drug system; In other primary medical institutions, the threshold is reduced from the original 40 yuan to 30 yuan each time.

The reimbursement limit for general outpatient expenses in the first tranche has been increased from the original 60 yuan to 80 yuan; The second level of payment is still 200 yuan. The proportion of the payment rate of the medical insurance for employees of the enterprise is 8% of the payment base of the unit and 2% of the payment base of the individual employee.

However, it should be reminded that the payment base of medical insurance for employees in different provinces and cities is different. Taking Guangzhou as an example, in 2017, the payment base of medical insurance for employees in Guangzhou was adjusted from 17,424 yuan to 18,561 yuan, and the lower limit was adjusted from 3,485 yuan to 3,712 yuan. In addition, the payment base for flexible employees to participate in social medical insurance for employees is 60% of the average monthly salary of on-the-job employees in the city in the previous year, that is, 3,712 yuan.

Summary. Hello Hello Hello <>Hello Hello

New regulations on medical insurance reimbursement in 2022: 1. Outpatient reimbursement If the hospital sees a doctor for minor illnesses and pains, it is generally more outpatient expenses. Then the employee medical insurance can directly deduct the outpatient expenses from the balance of their personal accounts, and the outpatient expenses of the resident medical insurance this year exceed 200 yuan, they can be reimbursed according to the proportion of 50%, and the maximum payment limit is 400 yuan.

2. There have been new changes in the hospitalization reimbursement this year, which is stipulated to be 200 yuan for grassroots doctors, 400 yuan for second-class hospitals, and 800 yuan for third-class hospitals. If the hospitalization expenses of the insured are above the starting line, then the reimbursement ratio of the employee medical insurance can be divided into % and 82% according to the level of these types of hospitals, while the reimbursement ratio of the resident medical insurance is % and 60% respectively, and it is stipulated that in the same natural year, the minimum payment standard for more than two (including two) hospitalizations is 50% of the first minimum payment standard.

New regulations on medical insurance reimbursement in 2022.

Hello Hello Hello <>Hello

New regulations on medical insurance reimbursement in 2022: 1. Outpatient reimbursement If the hospital sees a doctor for minor illnesses and pains, it is generally more outpatient expenses. Then the employee medical insurance can directly deduct the outpatient expenses from the balance of their personal accounts, and the outpatient expenses of the resident medical insurance this year exceed 200 yuan, they can be reimbursed according to the proportion of 50%, and the maximum payment limit is 400 yuan.

2. There has been a new change in the hospitalization reimbursement line this year, which is 200 yuan for grassroots doctors, 400 yuan for second-class hospitals, and 800 yuan for third-class hospitals. If the hospitalization expenses of the insured are above the minimum payment line, then the reimbursement ratio of the employee medical insurance can be divided into % and 82% according to the level of these types of hospitals, while the reimbursement ratio of the resident medical insurance is % and 60% respectively, and it is stipulated that in the same natural year, the minimum payment standard for more than two (including two) hospitalizations is 50% of the first minimum payment standard.

The reimbursement process of medical insurance is as follows: preparation of discharge records, medical records, and disease diagnosis. At the same time, these materials must be stamped.

Check out after being discharged from the hospital, do not lose the invoice, and the medical insurance department will receive the original. After returning to the local area, bring the information to the medical insurance reimbursement department for reimbursement. After the data is handed over, as long as the basic information is confirmed to be correct, a receipt will be given.

As long as there are no problems with the information provided, the reimbursement amount will arrive within 15 working days.

Summary. The new policy on the reimbursement ratio of medical insurance in 2022 is as follows: 1. Medical insurance is mainly divided into employee medical insurance and resident medical insurance, and the reimbursement ratio is also different; 2. The reimbursement ratio of employee medical insurance is divided according to the level of hospitalization expenses, the reimbursement ratio between 1,300 yuan and 30,000 yuan is 85, the reimbursement ratio between 30,000 yuan and 40,000 yuan is 90, the reimbursement ratio between 40,000 yuan and 100,000 yuan is 95, and the reimbursement ratio between 100,000 yuan and 300,000 yuan is 85;

The new policy on the reimbursement ratio of medical insurance in 2022 is as follows: 1. Medical insurance is mainly divided into employee medical insurance and resident medical insurance, and the reimbursement ratio is also different; 2. According to the division of hospitalization expenses in Yulafu, the reimbursement ratio between 1,300 yuan and 30,000 yuan is 85, the reimbursement ratio between 30,000 yuan and 40,000 yuan is 90, the reimbursement ratio between 40,000 yuan and 100,000 yuan is 95, and the reimbursement ratio between 100,000 yuan and 300,000 yuan is 85;

3. Residents' medical insurance is composed of the merger of urban residents' medical insurance and NCMS. The reimbursement ratio is 65 for Shouyedan first-class hospital, and the starting line is 300 yuan; The reimbursement ratio of secondary hospitals below 6,000 yuan is 65, and the reimbursement ratio of more than 6,000 yuan is 80, and the starting line of the second-level hospital in Qinzhong County is 400 yuan, and the starting line of the second-level hospital in the city is 600 yuan.

After I was discharged from the hospital, on the sixth day of hospitalization, I had the same condition, and now the hospital says I have to pay for it out of pocket.

Hello dear Generally is a compartment of 15 days at least. The interval between the second admission is not enough, and it does not exceed 15 days, and it cannot be reimbursed by medical insurance.

In this case, is health insurance useful?

Hello dear You can still buy medicine at designated pharmacies.