The following contents are for reference:
Policies related to hospitalization reimbursement:
(1) Qifubiaozhun and payment proportion within the policy: Qifubiaozhun and payment proportion within the policy for employee medical insurance are:
First-class medical institutions, second-class medical institutions and third-class medical institutions
Qifubiaozhun 300 yuan 500 yuan 700 yuan
The reimbursement rates are 98%, 95% and 90%.
The medical expenses within the scope of the policy refer to the part after deducting the advance expenses, bed fees, minimum payment standards, all out-of-pocket expenses, and over-limit expenses of price-limited materials. Qifubiaozhun means that the expenses incurred by the insured during hospitalization are within the above-mentioned standards (inclusive), and all expenses are paid by the insured; Exceeding the standard can be reimbursed according to relevant regulations.
If the insured is hospitalized several times within one year, the Qifubiaozhun for the second hospitalization will be reduced by 20% on the basis of the first Qifubiaozhun, and the Qifubiaozhun for the third and above hospitalization will no longer be reduced.
(2) Items that individuals need to pay in advance: 65,438+00% of Class B drugs, 8% of Class B medical items and 65,438+00% of Class C medical items.
(3) According to the medical insurance policy, the reimbursement scope of the insured person shall be implemented in accordance with the provisions of the Catalogue of Drugs for Basic Medical Insurance, Work Injury Insurance and Maternity Insurance in Jiangxi Province (version 20 10) and the Catalogue of Diagnosis and Treatment Items, Medical Service Facilities and Payment Standards of Basic Medical Insurance in Jiangxi Province (version 201KLOC-0/Trial Edition), which is beyond. The bed fee can be reimbursed for 20 yuan/day in tertiary hospitals, 6 yuan/day in secondary hospitals and 2 yuan/day in primary hospitals. The fees exceeding the standard shall be paid by themselves.
(4) Price-limited materials: The medical insurance policy stipulates the maximum price of high-value medical materials, and the expenses within the price limit shall be reimbursed according to the regulations, and the expenses exceeding the standard shall be borne by the insured.