Outpatient visits are reimbursed in this way
It only takes three steps
Step 1
The expenses within the scope of medical insurance incurred by insured employees and residents in the outpatient treatment of eligible designated medical institutions shall be settled and reimbursed in accordance with the provisions of the policy.
Step 2
After the diagnosis and treatment process is completed, you must go to the hospital's manual (medical insurance) window or self-service equipment for medical insurance settlement (if the medical institution provides medical insurance mobile payment services, you can directly settle the medical insurance through your mobile phone).
Step 3
At the time of settlement, show the medical insurance code (medical insurance electronic voucher) or swipe the social security card to accumulate the starting line, and the cumulative amount can be reimbursed after reaching the minimum payment standard. Steps to display the medical insurance code on WeChat: follow the WeChat public account of "Hefei Medical Insurance" or "Released by the Hefei Municipal People's Government", click "Service" - "Medical Insurance Code" - "Allow"; Alipay: Enter Alipay, search for "medical insurance code", and click "swipe medical insurance".
【Outpatient Reimbursement Treatment】
Primary general outpatient clinic
For outpatient treatment in the primary medical institutions (community health service centers or township health centers) in the insured place, the medical expenses will be reimbursed at a rate of 60%, and the annual reimbursement limit is 150 yuan. Patients with hypertension and diabetes can enjoy 70% reimbursement for the treatment of hypertension and diabetes in the primary outpatient clinic, with an annual limit of 360 yuan and 480 yuan respectively.
Large general outpatient services
The outpatient expenses of more than 500 yuan (200 yuan for a single entry) or more in the designated medical institutions above the second level in the insured place shall be reimbursed at a rate of 60%, and the annual reimbursement limit is 2,000 yuan.
For in-service employees who seek medical treatment in the general outpatient clinics of designated medical institutions, the minimum payment standard for first-level and below (including primary medical institutions) is 200 yuan, and the reimbursement ratio is 60%; In secondary and tertiary medical institutions, the minimum payment standard is 400 yuan, and the reimbursement ratio is 50%. The annual limit of outpatient reimbursement is 4,000 yuan. The reimbursement ratio for retirees will be increased by 10%, and the annual limit will be increased by 1,000 yuan. The purchase of drugs with the prescription of the designated medical institution in the outpatient co-ordination designated retail pharmacy shall be included in the scope of reimbursement, and shall be implemented according to the standards of first-level and below medical institutions, and the amount shall be included in the cumulative scope of the annual outpatient payment limit.
Source: Hefei Medical Insurance