What is the reimbursement ratio of remote medical insurance hospitalization?

Updated on society 2024-07-29
9 answers
  1. Anonymous users2024-02-13

    Under normal circumstances, 88% will be reimbursed for those below 3,000 yuan, and 90% for 3,000 to 5,000 yuan.

  2. Anonymous users2024-02-12

    The reimbursement ratio of non-local medical insurance is 70% to 95%, such as 70% reimbursement for valuable drugs, special examinations and special **; 80% for Class B drugs; 88% for those above the threshold fee of 3,000 yuan; 3000-5000 yuan reported 90%; 5,000-10,000 yuan reported 92%; 95% of the maximum payment limit for more than 10,000 yuan. The specific proportion of reimbursement also depends on the level of local economic development and the level of the hospital, and the reimbursement in other places will generally be lower than the local reimbursement.

    The process of handling medical reimbursement in other places:

    1.Before hospitalization or within 3 days after hospitalization, call the hometown NCMS consultation** to register and record the hospitalization and medical treatment;

    2.After being discharged from the hospital, a residence certificate must be issued by the sub-district office or neighborhood committee at the place of residence, and if you are working abroad, you must have a work certificate issued by the work unit;

    3.After discharge, take a copy of the medical record, a summary list, a hospitalization bill, and a discharge certificate, and then take the patient's ID card, cooperative medical certificate, and residence or work certificate back to the place where you participate in the hospital for reimbursement;

    4.If you are going directly from the place where you participate to inpatient chemotherapy outside the province, you must go through the referral procedures before you leave, and then you can go to other places for hospitalization**.

    Extended Materials. Reimbursement ratio of medical insurance for retired employees.

    1. Retired cadres and retired employees who participated in the work before the founding of the People's Republic of China, disabled personnel injured in the line of duty, third-stage silicosis patients, and second-class and first-class disabled servicemen who are hospitalized due to illness will be reimbursed 100% of their medical and drug expenses;

    2. Retired employees with more than 30 years of service will be reimbursed 90% of their medical and drug expenses;

    3. Retired employees with 21 to less than 30 years of service will be reimbursed 85% of their medical and drug expenses;

    4. Retired employees with 15 to 21 years of service will be reimbursed 80% of their medical and drug expenses;

    5. If the retired employee has less than 15 years of service, 75% of his medical and drug expenses will be reimbursed;

    6. 75% of the medical and drug expenses of retired employees will be reimbursed;

    7. 60% reimbursement of inpatient bed fees, regardless of any hospitalization method, will be charged for inpatient beds, and the hospital will collect those not collected by the company.

    Legal basis

    Social Insurance Law of the People's Republic of China

    Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be directly settled by the social insurance agency and the medical institution and the drug business unit. The administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits.

    Article 32 If an individual is employed across the overall planning area, the basic medical insurance relationship shall be transferred with him/her, and the payment period shall be calculated cumulatively.

  3. Anonymous users2024-02-11

    Hello, the reimbursement ratio of remote medical insurance is confirmed according to the specific fee. Different medical amounts have different proportions of reimbursement status, which should be confirmed and processed according to the actual situation. Different medical amounts and different proportions of reimbursement status, should be confirmed and processed according to the actual situation, the reimbursement share is 88% for the threshold fee above 3000 yuan, 90% for 3000-5000 yuan, 92% for 5000-10000 yuan, 95% for more than 10000 yuan to the maximum payment limit, during which 80% for Class B drugs, 70% for valuable drugs, and 70% for special inspections and special **.

    The medical expenses of the medical insurance personal account can be transferred to the Zigui Medical Insurance Bureau on a regular basis, and the hospitals in other provinces should be designated hospitals for local medical insurance.

  4. Anonymous users2024-02-10

    Pro, the reimbursement ratio for non-local fees is 88% for the threshold fee above 3,000 yuan, 90% for 3,000-5,000 yuan, 92% for 5,000-10,000 yuan, and 95% for more than 10,000 yuan to the maximum payment limit, of which 80% for Class B drugs, 70% for valuable drugs, and 70% for special examinations and special **.

    Questions. Hospitalization for appendicitis in a different place, no surgery at present, there was a catheter inserted before, how much can I be reimbursed if I am reimbursed.

    Hospitalization for appendicitis in a different place, no surgery at present, there was a catheter inserted before, how much can I be reimbursed if I am reimbursed.

    The scope of medical insurance reimbursement for appendicitis surgery varies according to the different hospitals in the region, and the level of medical insurance reimbursement is also different. The reimbursement is about 50% to 70%, of course, in addition to the self-pay, the bed fee, some examination fees are also not reimbursable, if the diagnosis is appendicitis, early choice of surgery is the best plan. It is recommended to go to the local hospital for a detailed consultation.

    Generally, the cost is between 8,000 and 10,000 yuan.

    Questions. There are also so many off-site reimbursements.

    There are also so many off-site reimbursements.

    Yes.

  5. Anonymous users2024-02-09

    The reimbursement ratio of non-local medical insurance is as follows: the reimbursement ratio is 88% for the threshold fee above 3,000 yuan, 90% for 3,000-5,000 yuan, 92% for 5,000-10,000 yuan, and 95% for more than 10,000 yuan to the maximum payment limit.

  6. Anonymous users2024-02-08

    First of all, in line with the provisions of the medical insurance in the place where you are insured, the individual pays first, and then goes back to the medical insurance department of the place where you participate in the insurance for reimbursement, and the reimbursement ratio is unchanged, which is the same as if you were hospitalized in the local area.

  7. Anonymous users2024-02-07

    Medicare is the reimbursement ratio of the local health insurance.

  8. Anonymous users2024-02-06

    Reimbursement ratio for medical treatment in other places in the province.

  9. Anonymous users2024-02-05

    Legal Analysis: There is a relationship between the reimbursement ratio of non-local medical insurance hospitalization and the medical expenses spent. The reimbursement ratio is 88 percent from the threshold fee to 3,000 yuan, 90 percent from 3,000 to 5,000 yuan, 92 percent from 5,000 yuan to 10,000 yuan, and 95 percent from 10,000 yuan to the highest payment limit, of which 80 percent for Class B drugs, 70 percent for valuable drugs, and 70 percent for special examinations and special inspections.

    Legal basis: Article 30 of the Social Insurance Law of the People's Republic of China The following medical expenses are not included in the scope of payment of basic medical insurance**

    1) It should be paid out of work-related injury insurance**;

    2) It shall be borne by a third party;

    3) It should be borne by public health;

    4) Seeking medical treatment outside the country.

    Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from a third party.

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