Hypertension and diabetes, referred to as "two diseases". Participate in the basic medical insurance for urban residents in our city, and the patients who are diagnosed with "two diseases" by our hospital and really need to take medicine. No deductible line is set. On the basis of the annual reimbursement of 450 yuan by the original outpatient department, the maximum payment limits of the annual medical insurance fund for hypertension and diabetes are 300 yuan and 400 yuan (drug treatment only). Suffering from "two diseases" at the same time, the annual maximum payment limit is 75% of the sum of the "two diseases" limit, that is, 525 yuan.
Medical insurance is one of the basic social security policies in China, which provides basic protection for the health of China residents.
Outpatient service: 60% of the medical expenses of village clinics and village center clinics are reimbursed, and the limit of prescription drugs per visit is 10 yuan, and the limit of prescription drugs for temporary rehydration by doctors in health centers is 50 yuan.
40% reimbursement is made by the town health center. The examination fee and operation fee for each visit are limited to 50 yuan, and the prescription fee is limited to 100 yuan.
The reimbursement for medical treatment in secondary hospitals is 30%, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan.
Third-level hospitals will be reimbursed 20%, and each visit will be limited to examination fees, operation fees, 50 yuan and prescription drugs, 200 yuan.
Traditional Chinese medicine invoice with prescription limit 1 yuan level cooperative medical outpatient annual compensation limit of 5000 yuan.
Hospitalization: reimbursement scope:
Medical expenses: auxiliary examination: the expenses for ECG, X-ray fluoroscopy, radiography, laboratory tests, physiotherapy, acupuncture, CT and MRI are limited to 200 yuan.
Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan). The elderly over 60 years old are hospitalized in health centers, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.
Reimbursement ratio: town health centers reimburse 60% hospitals, 40% hospitals and 30% hospitals.
Serious illness: If the medical expenses of inpatients participating in the cooperative medical system exceed 5,000 yuan at one time or cumulatively throughout the year, they should be compensated by stages, that is, 5001-kloc-0/0000 yuan is 65%, and1-kloc-0/8000 yuan is 70.
The annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan.
Legal basis: People's Republic of China (PRC) Social Insurance Law.
Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
Article 25 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.