According to the document "Notice on Standardizing the Outpatient Security System for Chronic Diseases and Special Diseases in the Province" (Liao Medical Insurance Fa [2022] 1 7), the Municipal Medical Security Bureau formulated the Interim Measures for the Management of Chronic Diseases and Special Diseases in the Outpatient Department of Yingkou Basic Medical Insurance, which was officially implemented on June 5438+ 10/day, 2023.

The proportion of medical insurance payment for employees is 85% for first-class and below medical institutions, 80% for second-class medical institutions and 75% for third-class medical institutions. The proportion of residents' medical insurance payment is 75% for first-class and below medical institutions, 70% for second-class medical institutions and 65% for third-class medical institutions.

Medical insurance reimbursement conditions

1, the insured person must go to the designated medical institution of basic medical insurance or the designated retail pharmacy determined by the social insurance institution with the medical prescription issued by the doctor in the designated hospital.

2. The medical expenses incurred by the insured in the process of medical treatment must conform to the basic medical insurance drug list, diagnosis and treatment items, the scope of medical service facilities standards and payment standards, and can be paid by the basic medical insurance fund according to regulations.

3. The medical expenses incurred by the insured that meet the payment scope of basic medical insurance shall be paid by the social medical pooling fund in a unified proportion, with the expenses above the Qifubiaozhun and below the maximum payment limit.