In 2025, the outpatient reimbursement limit for flexible employees' medical insurance in Tongchuan, Shaanxi, has the following key points: The annual maximum payment limit for the outpatient co-ordination of flexible employees is 2,000 yuan, and the reimbursement ratio varies according to the level of medical institutions. The specific situation is as follows:

1. Reimbursement ratio:

• For primary medical institutions (including township health centers and community health service centers), the reimbursement ratio is 70%. Such as common cold treatment in community health service centers, if the cost meets the regulations, 70% can be reimbursed.

• For secondary medical institutions, the reimbursement ratio is 60%. For example, if a flexible employee goes to a secondary hospital for outpatient treatment of gastritis, 60% of the eligible expenses will be reimbursed.

• For tertiary medical institutions, the reimbursement ratio is 50%. For instance, when seeing a doctor for a more complex disease in a tertiary hospital, 50% of the compliant outpatient expenses can be reimbursed.

2. Disease types:

• General outpatient services: For general diseases such as colds, fevers, and minor gastrointestinal discomforts, as long as they are treated in the above-mentioned corresponding-level medical institutions, the reimbursement can be carried out according to the corresponding ratio.

• Special disease outpatient services: For some special diseases, the reimbursement ratio may be different. For example, for 12 emergency diseases such as acute heart failure and severe trauma, the outpatient expenses are reimbursed at 80% - 95%. But it should be noted that specific special diseases need to refer to the local medical insurance policy list for clear regulations.

3. Calculation example: Suppose a flexible employee in Tongchuan goes to a secondary hospital for outpatient treatment of a certain disease, and the total medical expenses are 1,000 yuan, and all these expenses meet the medical insurance reimbursement scope. Then the amount he can be reimbursed is ​
   ×60%=
   yuan, and he needs to pay 400 yuan by himself. If the annual cumulative outpatient expenses of this employee reach 2,000 yuan, he will no longer be reimbursed for the remaining outpatient expenses in that year.

In general, the outpatient reimbursement policy for flexible employees' medical insurance in Tongchuan, Shaanxi in 2025 is designed to provide certain medical cost support for flexible employees. When seeking medical treatment, flexible employees should understand the local medical insurance policy clearly, choose the appropriate medical institution, and keep relevant receipts and certificates to ensure smooth reimbursement of medical expenses.