In daily life and work, people also pay great attention to the legal provisions of the reimbursement ratio of medical insurance in Chengdu. Many people may only have a certain understanding of it, but they may not be clear about it. Next, Xiaobian will bring you answers about the legal provisions of the reimbursement ratio of medical insurance in Chengdu, hoping to help you. I. Reimbursement ratio (1) The reimbursement ratio of medical insurance in the city is 92% in the first-level hospital, 90% in the second-level hospital, 85% in the third-level hospital, 2% in the age of 50, 4% in the age of 60, 89% (level 3) in the age of 70, 6% in the age of 80, and 8% in the same way. No more than 100% (II) Proportion and grade of medical insurance reimbursement for urban and rural residents. Pay the fee in the first class, second class, third class, first class 100 65% 60% 55% 35% second class 200 90% 80% 65% 50% third class 300 90% 85% 80% 65% students. 20 90% 80% 65% 50% (3) The proportion of medical insurance reimbursement in the province is increased by 2% for 50-59 years old and 4% for 60-69 years old based on the payment ratio formula (age *0.2+75)÷ 100. % 70-79 years old increases by 6% 80-89 years old increases by 8% in the same way, and does not exceed 100%. 2. Handling procedures 1. The handler submits reimbursement documents and other materials to the Dark Grey Insurance Fund Administration for acceptance; 2. The accepting department shall complete the examination, settlement and payment on the same day after receiving the application materials; 3 social insurance fund management bureau to review the materials and approve the application, the applicant to receive the "social medical insurance medical expenses reimbursement form", to be reimbursed. Note: If the application materials are incomplete, if the applicant needs to correct all the contents, the applicant shall correct the materials within 5 days from the date of receiving the Notice of Correction of Materials. If no correction is made within the time limit, the application shall be deemed to have been withdrawn. However, after the materials are corrected, the applicant may reapply within the statutory validity period. The applicant shall be reimbursed after receiving the "social medical insurance medical expense reimbursement form". Iii. Processing materials for reimbursement of hospitalization expenses of designated medical institutions: 1. Summary list of overall payment of hospitalization expenses; 2. Statement of overall payment of hospitalization expenses (the hospital must build official seal); 3. Hospitals that are not connected to the network must open special accounting tables, and hospitals that are connected to the network must open special accounting tables in special circumstances; 4. Special bills for hospitalization charges made or supervised by financial and tax departments; 5. List of expenses signed and approved by patients or their families; 6. Compound prescription of traditional Chinese medicine; 7. Certificate of discharge condition. Iv. reimbursement conditions: individuals begin to enjoy medical insurance benefits after six months of continuous payment for the first time; Unemployed persons who participate in (continue) medical insurance during the period of receiving unemployment insurance benefits or within 60 days after receiving unemployment insurance benefits shall enjoy medical insurance benefits from the next month of payment. Well, the above data is the relevant answers collected by Xiaobian about the legal provisions of the reimbursement ratio of medical insurance in Chengdu. I believe that everyone who carefully reads this article must have a clearer and deeper understanding of the legal provisions of the reimbursement ratio of medical insurance in Chengdu. If you need more legal answers, you can consult a lawyer online!

Legal objectivity:

What is the reimbursement rate of medical insurance? This is a very complicated problem, not to mention that the medical insurance policy has various regulations due to different regions, and even there are many kinds of medical insurance drugs. In addition, the proportion of outpatient reimbursement and hospitalization reimbursement is in short, this account is really difficult to calculate. 1. Different hospitals have different reimbursement rates for medical insurance. If a person spends 10000 yuan in a hospital, if he is hospitalized in a first-class hospital, then 500 yuan will be deducted first; If you are hospitalized in a secondary hospital, first subtract 1000 yuan; If you are hospitalized in a tertiary hospital, you will first subtract 2000 yuan; After that, the "non-medical insurance drug expenses" and "other non-medical insurance coverage expenses" were excluded, and the remaining employees reported 80%, and retired or unemployed, and unemployed 50%. Note: Medical insurance reimbursement only covers Class A drugs, that is, medical insurance drugs, and Class B drugs are non-medical insurance and cannot be reimbursed. 2. Reimbursement proportion of on-the-job employees for hospitalization medical insurance hospitalization, except for the self-funded part and the self-paid part of class B expenses 10%, the part that exceeds the threshold fee of hospital medical insurance enjoys the proportion of overall payment. Different hospital levels have different threshold fees, and the proportion of enjoying overall payment is also different. The proportion of medical insurance for employees is more than 80% (82%/84%/87% in Wuhan), and the proportion of medical insurance for residents is about 70% (80%/65%/50% in Wuhan). From this point of view, it is hard to say the proportion of self-paid medical insurance hospitalization. All self-paid parts are self-paid, and all threshold fees are self-paid. Class B expenses are self-paid first 10%, and then together with Class A expenses, they are self-paid by about 20%. It's complicated! In fact, the computer system will automatically calculate. When medical insurance is hospitalized, show the medical insurance card, read the card into the medical insurance system, pay the deposit (usually the threshold fee), and enter the expenses into the system. The system automatically classifies them as self-funded, Class A, Class B, etc. Class B pays 10% first, and then enters the basic medical care. According to the annual hospitalization times (more than 1 time threshold fee is halved), hospital level (. The calculation formula is as follows: if the medical expenses total 9000 yuan, the reimbursement formula is [9000-500 (deductible)-self-funded drugs ]*80%. If the self-funded drugs account for a large proportion, there is not much amount to be reimbursed. 3. Reimbursement ratio of retirees' supplementary medical insurance Ms. Zhang, who lives in Shijingshan District, Beijing, reported that after she retired in 2000, she had to go to the hospital for medical treatment and prescription every month because of chronic diseases. In the past, the reimbursement ratio was always about 88% (for retirees under 70 years old, 70% was paid by mutual funds for large medical expenses, and 60% of the remaining 30% could be reimbursed by supplementary medical insurance, which was 88%). But now it is said that the proportion of supplementary medical insurance in the social security card (that is, the medical insurance card) is 50%, so only 85% can be reimbursed. She wants to know whether the social security card has adjusted the proportion of medical reimbursement. The staff of the Social Security Bureau replied that the social security card did not adjust the proportion of any medical reimbursement. According to the Beijing Basic Medical Insurance Regulations issued in 2005, the social supplementary medical insurance for retirees under 70 years old is 50%. If the reimbursement ratio of Ms. Zhang's supplementary medical insurance is 60%, it should be because the funds reimbursed by Ms. Zhang's original unit are higher than the social supplementary medical insurance. After using the social security card, it can still be reimbursed according to the reimbursement ratio provided by the original unit, that is, 60% of the supplementary medical insurance.