1. When employees' medical insurance participants go to the general outpatient department of a designated medical institution, they can first use the outpatient co-ordination fund for reimbursement, and then pay in personal account or cash.

2, in an insured year, the insured in the designated medical institutions within the scope of the basic medical insurance payment for outpatient medical expenses Qifubiaozhun accumulated for 600 yuan.

3. The payment limit of the on-the-job personnel pooling fund is 1.200 yuan per person per year, and the payment limit of retirees is 1.800 yuan per person per year.

4, outpatient medical expenses payment limit, calculated according to the insured year, more than the annual payment limit of medical expenses paid by individuals, the annual limit will not be carried forward.

5. Payment ratio: Outpatients will not pay items that are not paid by basic medical insurance, such as public health expenses, physical health or health insurance consumption, health check-ups, etc.

6. Expense settlement method: Like hospitalization settlement, outpatient medical expenses are accumulated in the medical insurance system, and can be directly settled and reimbursed in designated medical institutions with social security card or medical insurance electronic certificate.

The scope of outpatient co-ordination:

1. Drug expenses, diagnosis and treatment expenses and medical consumables expenses in the medical insurance catalogue: The expenses of Class A and Class B drugs, diagnosis and treatment expenses and medical consumables in the medical insurance catalogue of designated medical institutions are included in the overall planning scope of employee outpatient service. Among them, Class A medical expenses are fully included, and Class B medical expenses are included after paying 10%.

2. Routine outpatient medical expenses: Staff outpatient co-ordination mainly aims at reimbursement of routine outpatient medical expenses, such as common diseases and frequently-occurring diseases. The outpatient treatment expenses for special diseases or major diseases shall not be included in the scope of outpatient co-ordination.

3. Designated medical institutions: Insured persons need to undergo outpatient treatment in designated medical institutions designated by the medical insurance department in order to enjoy outpatient reimbursement.

To sum up, the use of outpatient co-ordination varies according to regions and policies, and the insured needs to know the local specific regulations and usage methods. Before use, you should consult the local medical insurance department or medical institution to ensure that you can enjoy the reimbursement treatment of outpatient co-ordination correctly.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.