We know that participating in medical insurance brings us a lot of benefits. When you are ill and cannot afford to pay the expensive medical expenses when you are in hospital, you can reimburse part of the expenses through medical insurance. Can you swipe the medical insurance card when you see a doctor from another place? What is the reimbursement proportion of medical insurance card?
Do you need to swipe the medical insurance card to see a doctor in another place
Medical insurance can be directly settled across provinces. Use process in different places: first record, select fixed point, and get medical treatment with card.
Step 1: record first
First filing refers to that the insured personnel need to be filed in the agency of the insured area before cross provincial medical treatment. The agency collects necessary information. At present, there is a unified filing form in China, which is clear, and the key information is two. First, it is necessary to clarify the reasons for filing, whether you go out to stay or settle down in a different place, or work outside, or transfer to a hospital, and tell the handling agency the reasons. Second, where to go. After the agency collects these two key information, it will be transferred to the national settlement system, to relevant regions and medical institutions, and other information social security cards, such as name and card number, do not need to be collected separately.
Step 2: select a point
Selecting a fixed point means that the masses need to choose a fixed-point medical institution (pay attention to the cross provincial fixed-point medical institution), such as choosing to go to Beijing and Shanghai to see a doctor, and going to the fixed-point medical institution of cross provincial and different places to see a doctor. You can find out in real time which institutions, what level and where on the published website. More and more medical institutions are available for the insured to go to other places.
Step 3: medical treatment with card
The most critical step is to apply for admission registration and discharge settlement. Patients must use social security card, and apply for admission and settlement.
No matter the employees, urban residents and rural residents, as long as they keep records according to the regulations and fulfill the corresponding procedures, they can enjoy the direct settlement of inter provincial hospitalization expenses.
What is the reimbursement ratio of
After going to the medical insurance, if it is an on-the-job employee, the medical expenses of more than 2000 yuan can be reimbursed after going to the outpatient and emergency department of the hospital, and the proportion of reimbursement is 50%. For retirees under the age of 70, expenses over 1300 yuan can be reimbursed, accounting for 70%. For retirees over 70, 80% of the expenses above 1300 yuan can be reimbursed. No matter what kind of people, the maximum amount of outpatient and emergency medical expenses is 20000 yuan.
For the ordinary outpatient expenses incurred by the insured employees in the primary medical institutions implementing the national basic drug system, there is no starting line for their treatment payment; for the expenses incurred in other primary medical institutions, the starting line standard is reduced from the original 40 yuan to 30 yuan each time. The reimbursement limit of first-class ordinary outpatient expenses was increased from 60 yuan to 80 yuan, while that of second-class payment was still 200 yuan.
The payment proportion of medical insurance for enterprise employees is: 8% of the unit's payment base, and 2% of the individual's payment base. However, we need to remind that the payment base of medical insurance for employees in different provinces and cities is different. Take Guangzhou as an example. In 2017, the payment base of medical insurance for Guangzhou employees was adjusted from 17424 yuan to 18561 yuan, and the lower limit was adjusted from 3485 yuan to 3712 yuan. In addition, the payment base for flexible employees to participate in social medical insurance for employees is 60% of the average monthly wage of the city's on-the-job employees in the previous year, namely 3712 yuan.
In addition, after September 1, Beijing also announced the payment standard of medical insurance in 2017:
The individual payment amount of urban elderly is 360 yuan per person per year;
The individual payment amount of students and children is 160 yuan per person per year;
The individual payment amount of urban unemployed residents is 660 yuan per person per year, of which the individual payment amount of disabled unemployed residents is 360 yuan per person per year.
We can answer from the reimbursement proportion, general outpatient reimbursement, serious illness reimbursement and other aspects.
（1） According to the first payment, 80% of the inpatient medical expenses incurred in the first level hospital implementing the basic drug system (90% of the basic drug system) and 60% in the hospital not implementing the basic drug system; 58% in the second level hospital; 45% in the third level hospital.
（2） For the second level payment, 85% will be paid by the first level hospital (90% for basic drugs), 70% by the second level hospital and 60% by the third level hospital.
（3） Minor residents and special groups shall enjoy the medical insurance treatment of second-class payment.
The starting standard for reimbursement of inpatient medical expenses: 300 yuan for the first level hospital, 500 yuan for the second level hospital and 700 yuan for the third level hospital. If a patient with malignant tumor is hospitalized for many times due to radiotherapy or chemotherapy within a medical insurance year, the starting line shall be deducted only once.
The outpatient medical expenses incurred by the insured employees in the designated designated community health service center or township health center shall be paid by the general outpatient co-ordination fund in the proportion of 50%. For the ordinary outpatient expenses incurred by the insured employees in the primary medical institutions implementing the national basic drug system, there is no starting line for their treatment payment; for the expenses incurred in other primary medical institutions, the starting line standard is reduced from the original 40 yuan to 30 yuan each time. The reimbursement limit of first-class ordinary outpatient expenses was increased from 60 yuan to 80 yuan, while that of second-class payment was still 200 yuan.