Proportion of medical insurance reimbursement in Shanghai

In order to alleviate the dilemma of "it is difficult and expensive to see a doctor" for the insured in Shanghai, the government has also carried out some related reforms on the proportion policy of medical insurance reimbursement in Shanghai. So what is the proportion of medical insurance reimbursement in Shanghai? Let's take a look with Bian Xiao. Especially in terms of the speed of residents in Shanghai, the proportion reimbursement of basic medical insurance in Shanghai is divided into outpatient and emergency reimbursement and hospitalization reimbursement, both of which greatly reduce part of the expenses of residents' medical treatment and further bring good protection for residents' medical treatment.

1. Outpatient emergency reimbursement ratio The threshold for outpatient emergency reimbursement of insured persons is: elderly people aged 60 and above, severely disabled people, primary and secondary school students and infants 300 yuan; /kloc-500 yuan for people over 0/8 and under 60. The part exceeding the Qifubiaozhun shall be paid by the urban and rural residents' medical insurance fund according to the following proportions: 70% of outpatient emergency services in community health service centers (or first-class medical institutions); Second-level medical institutions outpatient emergency 60%; In the third-level medical institutions outpatient emergency, pay 50%. The medical expenses incurred by the insured in the village clinic clinic are not included in the Qifubiaozhun, and 80% are paid by the urban and rural residents' medical insurance fund.

2. The threshold of hospitalization reimbursement ratio (including emergency observation room observation) is: 50 yuan, a first-level medical institution; Kloc-0/00 yuan, a second-level medical institution; and 300 yuan, a third-level medical institution. The medical expenses incurred by insured residents in each hospitalization, which exceed the Qifubiaozhun, shall be paid by the urban and rural residents' medical insurance fund according to the following proportions: 90% of the elderly and severely disabled people over 60 years old who are hospitalized in community health service centers (or first-class medical institutions); If you are hospitalized in a secondary medical institution, you will pay 80%; 70% for hospitalization in tertiary medical institutions; Persons under the age of 60 pay 80% for hospitalization in community health service centers (or first-class medical institutions), 75% for hospitalization in secondary medical institutions and 60% for hospitalization in tertiary medical institutions. The above is an introduction to the proportion of medical insurance reimbursement in Shanghai. Shanghai's policy of appropriately increasing the reimbursement rate of outpatient and emergency departments to further reduce the economic burden of patients is an important measure to serve the people and promote the harmonious and stable development of society.