In 2025, the outpatient reimbursement ratio of critical illness insurance in Tangshan, Hebei varies depending on different situations. Here is a detailed introduction:
- General outpatient expenses: For ordinary outpatient expenses of insured urban and rural residents in designated medical institutions, the reimbursement ratio within the policy scope is 50%. The reimbursement amount ranges from 50 yuan to 140 yuan according to the number of consecutive years of payment. For example, those who have continuously paid for 5 - 9 years since 2017, the individual outpatient co - ordination annual maximum payment limit is increased to 80 yuan per person per year; for those who have continuously paid for 10 - 19 years, it is increased to 110 yuan per person per year; for those who have continuously paid for 20 years and above, it is increased to 140 yuan per person per year; for others, the individual outpatient co - ordination annual maximum payment limit remains 50 yuan per person per year.
- Outpatient expenses for special chronic diseases: For outpatient expenses of chronic diseases and special diseases such as outpatient radiotherapy and chemotherapy for malignant tumors, dialysis for uremia, and anti - rejection treatment after organ transplantation, they are included in the fund payment scope and are managed and paid with reference to inpatient care. The specific reimbursement ratio may vary according to different diseases and policies, but generally, it is designed to provide strong support for patients with such serious diseases. For example, for some specific major diseases, after the basic medical insurance reimbursement, the critical illness insurance will further reimburse the remaining self - paid expenses according to a certain proportion.
- "Two diseases" (hypertension and diabetes) outpatient drug expenses: The outpatient drug expenses for "two diseases" (hypertension and diabetes) can also be reimbursed according to regulations. The reimbursement ratio is 50%. The maximum payment limit for diabetes is 375 yuan, and for hypertension is 225 yuan. This policy helps patients with these two common chronic diseases better control their conditions and reduces their economic burden.
In general, the outpatient reimbursement policy of critical illness insurance in Tangshan, Hebei in 2025 is designed to provide more comprehensive medical security for the public, especially those with serious diseases and chronic diseases. When seeking medical treatment, it is recommended that insured persons understand relevant policies in advance, keep relevant medical bills and materials, and go through the reimbursement procedures in accordance with regulations to enjoy corresponding benefits.