In Wuhan, the medical reimbursement ratios in secondary and tertiary hospitals vary depending on different medical insurance types. For employees' medical insurance in inpatient services, the reimbursement ratio in secondary hospitals is 89% for active employees and 91.2% for retirees; while in tertiary hospitals, it is 86% for active employees and 88.8% for retirees. For urban and rural residents' medical insurance in inpatient services, the reimbursement ratio in secondary hospitals is 70%, and in tertiary hospitals is 60%.
Here are the details:
- Employees' Medical Insurance
- Inpatient Reimbursement: In secondary hospitals, active employees can be reimbursed 89% of the eligible medical expenses, and retirees can be reimbursed 91.2%. In tertiary hospitals, the corresponding ratios are 86% for active employees and 88.8% for retirees. For example, if an active employee spends 10,000 yuan in a secondary hospital, and the eligible medical expenses are 8,000 yuan, then the amount reimbursed by medical insurance is yuan.×89%=
- Outpatient Reimbursement: For general outpatient services in secondary hospitals, active employees can be reimbursed 65% and retirees 75%. In tertiary hospitals, active employees can be reimbursed 55% and retirees 65%. For instance, if a retiree spends 500 yuan on general outpatient services in a tertiary hospital, and all are eligible medical expenses, the amount reimbursed by medical insurance is yuan.×65%=
- Urban and Rural Residents' Medical Insurance
- Inpatient Reimbursement: In secondary hospitals, the reimbursement ratio is 70%, and in tertiary hospitals is 60%. For example, if a resident spends 15,000 yuan in a tertiary hospital, and the eligible medical expenses are 10,000 yuan, then the amount reimbursed by medical insurance is yuan.×60%=
- Outpatient Reimbursement: The general outpatient reimbursement ratio is 50% for both secondary and tertiary hospitals, but there is a certain annual payment limit.
It should be noted that the above ratios are based on the policy within the scope of eligible medical expenses. Expenses for items not covered by the medical insurance catalog need to be borne by individuals themselves. When seeking medical treatment, it is recommended that everyone understand the local medical insurance policy in advance to ensure that they can enjoy the corresponding medical insurance benefits.