1. Above the deductible line for reimbursement of hospitalization medical expenses: the standards of inpatient deductible line are: tertiary hospital 500 yuan, secondary hospital 400 yuan, primary (including substandard) hospital 300 yuan, and community hospital (including township hospitals) 200 yuan. For those who have been hospitalized for many times within one year, the deductible will decrease by 50 yuan in turn, but the minimum is not less than 100 yuan.
2. The reimbursement rate of hospitalization medical expenses above the deductible line that meets the scope of medical insurance reimbursement is: 55% reported by tertiary hospitals. Second-level hospitals reported 60%, first-level hospitals reported 65%, and community hospitals (including township hospitals) reported 70%.
3. The maximum payment limit of the basic medical insurance fund for urban residents is 30,000 yuan per year.
4. The medical expenses of serious illness outpatients are not classified into different levels, and the deductible standard is unified as 200 yuan, and the reimbursement rate is 65%.
Payment standard of inpatient bed fee
1, the payment standard of the basic medical insurance pooling fund for inpatient bed fee is unified, and the specific payment standard is as follows: tertiary hospital: 35 yuan/bed day; Level II Hospital: 25 yuan/Bed Day; Grade I and unclassified hospitals: 15 yuan/bed day; ICU and CCU beds): 60 yuan/Bed Day. If the insured bed fee is lower than the payment standard, it shall be calculated according to the actual bed fee; if it is higher than the payment standard, it shall be calculated according to the payment standard.
2. The over-standard hospital bed fee for county-level cadres who enjoy Medicaid for civil servants shall be separately included in Medicaid for business, and the price limit shall be used to make up the difference (people above the deputy level shall enjoy the subsidy for cadres at the prefecture-level separately). The specific subsidy price limit standards are as follows: tertiary hospitals do not exceed 30 yuan/bed day; The second-level hospital does not exceed 20 yuan/bed day; No more than 15 yuan/bed days in secondary hospitals: no more than 10 yuan/bed days in hospitals below secondary hospitals; The beds in ICU and CCU shall not exceed 20 yuan/bed day.
Two, Sichuan urban residents medical insurance online payment important reminder:
In 2022, the deadline for centralized financing of basic medical insurance for urban and rural residents and supplementary medical insurance for serious illness was extended to February 28, 2022.
During the period of centralized fund-raising, those who have completed the payment of basic medical insurance for urban and rural residents and supplementary medical insurance for serious illness in 2022 will begin to enjoy treatment from June 65438+ 10/.
In 2022, the financing standard of medical insurance for urban and rural residents was freshly released!
Study on payment methods of medical insurance for urban and rural residents in Chengdu
1, online payment
"Chengdu Medical Insurance" WeChat official account "Convenience Service-Intensive Platform-Payment of Endowment Medical Insurance-Sichuan Electronic Taxation Bureau of People's Republic of China (PRC) State Taxation Bureau"
"Chengdu Tax" WeChat official account "I want to do things-social security payment";
Wechat "I-Payment-City Service-Social Security-Sichuan Social Security Payment-Sichuan Social Security Payment";
Alipay "Citizen Center-Social Security-Social Security Payment";
Tianfu citizen cloud "social security payment-online insurance payment";
Mobile banking, WeChat banking and online banking provided by the social security fee collection bank. (At present, the banks that provide social security payment services for urban and rural residents in Chengdu are: China Construction Bank, Industrial and Commercial Bank of China, Agricultural Bank, China Bank, Sichuan Tianfu Bank and Chengdu Rural Commercial Bank, and the specific payment methods shall be subject to bank regulations).
2. Offline payment
Township (street), village group (community) social security payment service outlets;
Schools and kindergartens accept it.