The reimbursement rate of medical insurance in other places is too low

You can hand over the premium money to one place and go to another place for medical treatment, that place must not receive the money to give you the same reimbursement treatment, otherwise it will be unfair to the people who pay the money to that place, if you want to be fair, then find a way to pay social security where you want to seek medical treatment, of course, there is also a way to buy commercial medical insurance insurance, as long as the hospital meets the insurance requirements, and the medical expenses meet the terms and conditions of reimbursement, the remaining part of the social security reimbursement will be borne by the commercial insurance after deducting the deductible.

1. The reimbursement ratio of medical insurance for medical treatment in other places in the province.

Since China's medical insurance policy is not unified across the country, there are certain differences in the proportion and scope of medical insurance reimbursement in different regions.

Therefore, the provisions on medical treatment in other places are that the insured who has gone through the relevant filing procedures for medical treatment in other places shall be subject to the reimbursement items according to the medical insurance catalogue of the place of medical treatment, and the proportion of reimbursement shall be subject to the proportion of reimbursement in the place of insurance, but it is usually lower than the proportion of reimbursement for medical treatment in the place of insurance.

If the insured person does not go through the referral procedures and goes to a designated medical institution outside the overall medical insurance co-ordination for treatment, then the proportion of medical insurance reimbursement is about 30% lower than that of the designated medical institution in the co-ordination area, whether it is the medical care for urban employees or the basic medical care for urban and rural residents. Therefore, you must go through the filing and referral procedures for medical treatment in other places before you go to a different place.

2. The process of reimbursement for medical treatment in other places.

1. Filing. The insured person should bring his or her ID card, social security card and specific supporting materials (such as long-term residence permit in another place, certificate of work in other places issued by the company, referral certificate, etc.) to the local medical insurance agency to go through the filing procedures for medical insurance in other places.

2. Select the point.

When applying for the record, it is necessary to select a designated medical institution for medical treatment in a different place, and only by seeking medical treatment in the selected medical institution can the medical expenses be reimbursed.

3. Seek medical treatment with a card.

After completing the filing procedures, you can directly swipe the medical insurance card for reimbursement when you seek medical treatment in a designated medical institution that has been networked nationwide.

Legal basis: Article 29 of the Social Insurance Law of the People's Republic of China stipulates that 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 institutions and drug business units. 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 28 of the Social Insurance Law of the People's Republic of China conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and emergency and rescue medical expenses, in accordance with national regulations from the basic medical insurance **.

The reimbursement ratio of non-local medical insurance is determined 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 medical insurance bureau on a regular basis, and the hospitals in other provinces should be designated hospitals for local medical insurance.

1. What is the reimbursement ratio of medical insurance in different places?1. The proportion of medical insurance reimbursement in other places is generally 70% to 95%. Reimbursement of 70% for valuable medicines, 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.

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2. Legal basis:

Social Insurance Law of the People's Republic of China

Article 28 In line with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards and emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance ** pay for the burial.

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

1. Talk about the reimbursement ratio of medical insurance for burial in different places1. The proportion of medical insurance reimbursement in other places is generally 70% to 95%. Reimbursement of 70% for valuable medicines, special examinations and special treatments for burial treatments; 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.

2. Legal basis:

Social Insurance Law of the People's Republic of China

Article 28 In line with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards and emergency and rescue medical expenses, in accordance with national regulations including the basic medical insurance ** pay for the burial.

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