1, 60% reimbursement for visits to village clinics and village center clinics, prescription drug cost limit for each visit 10 yuan, and prescription drug cost limit for temporary rehydration for doctors in health centers in 50 yuan;
2. 40% reimbursement for medical treatment in the town health center, with the limit of 50 yuan for each examination and operation, and the limit of prescription drug fee 100 yuan;
3, the secondary hospital reimbursement of 30%, each examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan;
4, tertiary hospital reimbursement of 20%, each visit examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan;
5. Chinese medicine invoice with prescription 1 yuan per paste;
6, the township cooperative medical outpatient compensation limit is 5000 yuan.
Medical insurance coverage:
1, reimbursement of basic medical insurance drugs: our country now divides drugs into three categories: A, B and C, of which A drugs are within the scope of medical insurance, so medical insurance can only reimburse A drugs, and B and C drugs cannot be reimbursed;
2. Reimbursement of basic medical service facilities: this reimbursement scope mainly refers to bed fees, first-aid bed fees, medical treatment fees, etc. Expenses incurred by the insured in the process of medical treatment and nursing in designated medical insurance institutions;
3. Reimbursement of basic medical insurance diagnosis and treatment items: it must be a safe and effective diagnosis and treatment item, and the charging standard shall be determined by the price department. Need to be treated in a designated medical institution.
To sum up, China's medical insurance is divided into employee medical insurance and urban residents' medical insurance. According to different types of medical insurance, the actual participation conditions are different, and the scope, conditions and standards of reimbursement are also different. The specific medical insurance reimbursement policy can be determined by consulting the local medical insurance bureau and combining the types of medical insurance you have invested.
Legal basis:
Article 25 of People's Republic of China (PRC) Social Insurance Law
The state establishes and improves the basic medical insurance system for urban residents.
The basic medical insurance for urban residents combines individual contributions with government subsidies.
People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.