The reimbursement ratio of local medical insurance and the reimbursement ratio of other places

Legal analysis: Generally speaking, the reimbursement ratio of medical treatment in other places is lower than that of the local one, and the reimbursement ratio of the foreign medical insurance bought in the local medical treatment is lower than that of the local medical insurance, if it is a grassroots hospital, the local may be reimbursed about 80, and the non-local one is only 40 60.

Legal basis: Social Insurance Law of the People's Republic of China

Article 2: The State shall establish social insurance systems such as basic endowment insurance, basic medical insurance, work-related injury insurance, unemployment insurance, and maternity insurance, to protect citizens' right to receive material assistance from the State and society in accordance with law in the event of old age, illness, work-related injury, unemployment, childbirth, and so forth.

Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the provisions of the State.

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

It's not the same. 1. It's different.

2. Generally speaking, the reimbursement ratio of medical treatment in other places is lower than that of the local one, and the reimbursement ratio of the medical insurance bought in the local area is lower than that of the local medical insurance, if it is a grassroots hospital, the local hospital may be reimbursed about 80, and the non-local one is only 40 60.

3. Since the opening of the policy of medical insurance reimbursement in other places, it has been convenient for many people who work in other places, and at the same time, some elderly people who have settled down in other places with their children can also save the trouble of traveling and traveling. However, for medical treatment in other places, the reimbursement ratio of medical insurance is lower than that of local reimbursement, according to the reimbursement principle of the directory of medical treatment, the policy of the place of insurance, and the management of the place of medical treatment".

4. The proportion of reimbursement in different places should be estimated according to the local regulations, and the policies of each place will be different, so you can prepare all the relevant materials first.

If it is an emergency medical treatment and it is too late to file with the medical insurance institution in the insured place, you can file with the medical insurance institution in the insured place within 5 days after the occurrence of the medical act, and take the emergency certificate of the emergency hospital to participate in the reimbursement when reimbursing.

If there is no such series of procedures, the reimbursement ratio will still be affected, and the threshold fee will increase a lot, and it may only need a threshold fee of 400 yuan, if you do not file for the record, the threshold fee is likely to be increased to about 1000, in order to be reimbursed for your own medical insurance expenses, and in order to be reimbursed smoothly, you must do a good job in the filing of remote treatment.

Answer: Pro, the reimbursement ratio in different places is 88% for the threshold fee above 3000 yuan, 90% for 3000-5000 yuan, 92% for 5000-10000 yuan, and 95% for more than 10000 yuan to the maximum payment limit, of which 80% for Class B drugs, 70% for valuable drugs, and 70% for special inspections and special **.

Question: Hospitalization for appendicitis in a different place, I can't do surgery at present, and I have a catheter inserted before, how much can I be reimbursed if I am reimbursed?

Hospitalization for appendicitis in a different place, currently unable to do surgery, there was a catheter inserted before, how much can be reimbursed if reimbursed Answer: Appendicitis surgery is reimbursed according to different hospitals in different regions, and the scope of medical insurance reimbursement is also different for different levels. 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.

Question: There are so many reimbursements in different places.

There are also so many off-site reimbursements.

The proportion can reach about 90%, even if medical reimbursement is carried out in a different place, there are benefits, and these are related processes.

It's about 60%, which shows that it is not cost-effective to reimburse medical insurance expenses in other places, so this also warns some people that if they want to be reimbursed in their daily life, they must go to the local area for reimbursement.

The proportion of off-site reimbursement is lower than that of local reimbursement, generally around 60%.

Now the state has implemented a new medical insurance policy, and has also improved the relevant medical insurance reimbursement regulations. So now medical insurance can be reimbursed in other places, if you feel that the local medical resources are not very good, you can go to other places to see a doctor, and you can also apply for medical insurance reimbursement when you see a doctor in a different place. Generally speaking, what is the proportion of medical insurance reimbursement in other places?

What is the reimbursement rate of remote medical insurance?

The state is particularly concerned about the health of the grassroots people, and has specially launched a medical insurance policy so that more people can afford to see a doctor and are no longer afraid to go to the hospital to see a doctor. If you see a doctor in a different place, you must bring the relevant materials and return to your hometown to be reimbursed, but now the relevant policies have been perfected, and the medical insurance can also be rented to be reimbursed in other places. The proportion of reimbursement for non-local medical insurance is a little lower than that of local reimbursement, generally around 60%.

Off-site reimbursement is not cost-effective as local reimbursement.

If you reimburse the medical insurance locally, the reimbursement ratio may reach 80%, for example, if you spend 1,000 yuan on hospitalization, you only need to pay 200 yuan yourself, and the remaining 800 yuan can be reimbursed. Therefore, even if the medical insurance can be reimbursed in other places, it is not recommended to do so, after all, the reimbursement is greater in the local reimbursement, and it can also reduce the financial burden of your family. Therefore, if you are seeing a doctor in a different place, you still need to keep the relevant transfer certificate and medical payment list, and then submit these materials to the staff of the local medical insurance center after returning to the local medical insurance center, so that they can reimburse you.

Summary. I also believe that in the future, the health insurance policy will definitely become more and more sound, so that people can get better reimbursement benefits, even if they are in other places, they will be able to enjoy the local reimbursement ratio. We must also believe in the construction of the country, and the reimbursement of medical insurance will only get better and better.

The reimbursement ratio of remote reimbursement should be able to reach 60%, depending on your own disease situation and the policies of each region.

Hello, I am glad to answer for you, the in-service employees and flexible employees who participate in the basic medical care insurance for employees are 40%; 25% for retirees. 60% of the elderly residents and the disabled participate in the basic medical insurance for urban residents; 40% for minor residents, college students, and low-income people.

The general reimbursement ratio is about 60%, and it is not cost-effective to use remote reimbursement of medical insurance expenses, and if there are conditions, you should go back to the local area for reimbursement.

Generally speaking, the reimbursement ratio of remote medical insurance reimbursement is about 5:1, and only 1 5 money can be reimbursed.

The ratio should be only between 30% and 55%. The main reason is that if you reimburse in other places, the reimbursement ratio is generally not very large.

This is uncertain because different places have different reimbursement ratios, and policies are different in different cities.

The ratio of reimbursement from non-local medical insurance to local reimbursement is as follows:

1. Reimbursement ratio of non-local medical insurance.

The reimbursement ratio shall be handled according to local policies, 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 inspections and special **.

2. Local reimbursement ratio.

The reimbursement ratio for first-level hospitals is 65%, the reimbursement ratio for second-level hospitals above 6,000 is 80%, and the reimbursement ratio for hospitalization of employee medical insurance is 85% for hospitalization expenses between 1,300 yuan and 30,000 yuan, 90% for hospitalization between 30,000 yuan and 40,000 yuan, 95% for Baoxiang pickpocketing between 40,000 yuan and 100,000 yuan, and 85% for 100,000 yuan and 300,000 yuan.

How to check medical insurance:

1. You can make a query through the network, through the official WeChat or official website of the local medical insurance bureau, you can search for medical insurance inquiries on WeChat, and then click to enter the registration and log in to your own, and then you can see the historical payment information, and you can also query the multi-cherry banquet holding information and handle a number of businesses.

2. You can make an inquiry through **, and you can dial ** to ask about the relevant letter of the Health Insurance Bureau.

3. You can go to the local medical insurance bureau to make an inquiry, and if you generally inquire about the information, you can go through ** or the Internet. <>

The reimbursement ratio of non-local hospitals is not the same as that of local hospitals. Generally speaking, the reimbursement ratio of medical treatment in other places is lower than that of the local one, and the reimbursement ratio of the medical insurance bought in the local area is lower than that of the medical insurance bought locally, if it is a grassroots hospital, the local hospital may be able to reimburse about 80, and the local one is only 40 60.

Article 28 of the Social Insurance Law.

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance in accordance with national regulations.

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 social insurance administrative department and the health administrative department shall establish a system for settling medical expenses for medical treatment in other places to facilitate the enjoyment of basic medical insurance benefits by insured persons.

The reimbursement rate for non-local medical insurance is generally 70% to 95%. Under normal circumstances, the cost of valuable drugs, special examinations and special ** will be reimbursed at a rate of 70%, and the cost of Class B drugs will be reimbursed at a rate of 80%.

Social Insurance Law of the People's Republic of China

Article 28.

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance in accordance with national regulations.

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 blind and prudent insurance** shall be directly settled by the social insurance agency and the medical institution and the drug business unit.

The social insurance administrative department and the health administrative department shall establish a system for settling medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits.