#Media People Weekly##Tangshan Headlines#Tangshan New News: The ratio of payment between the individual and the pooled fund of medical insurance is such a →
Recently, some netizens have consulted: I want to consult how to stipulate the ratio of medical insurance personal payment and medical insurance payment? Do pharmacies pay the same as this ratio?
Replies:1. In a calendar year, for outpatient medical expenses within the policy scope of the pooled fund, the minimum payment standard for the general outpatient clinic of employee medical insurance is 100 yuan, the proportion of payment by the pooled fund to the active and retired personnel is 50% and 60%, and the payment limit is 800 yuan and 1000 yuan, respectively.
2. General designated pharmacies need to be paid by the employee's medical insurance personal account or cash, and the pooled fund will not pay.
3. The proportion of hospitalization payment for the basic medical insurance of urban employees in designated medical institutions at the first level and below in our city is 93% of the insured personnel and 96% of the retired insured personnel; the proportion of the basic medical insurance payment of the basic medical insurance of the urban employees of the second-level designated medical institutions is 90% of the insured personnel and 93% of the retired insured personnel; the proportion of the basic medical insurance payment of the basic medical insurance of the urban employees of the third-level designated medical institutions is 85% of the insured personnel and 88% of the retired insured personnel. When seeking medical treatment in different places across provinces, after the individual pays 10% of the inpatient medical expenses of designated medical institutions within the scope of medical insurance, the minimum payment standard and reimbursement ratio are implemented according to the hospitalization standards of the third-level medical institutions in our city. #Tangshan's side affairs#Ask for attention [Zuoyi]
