From January 1, 2024, the city will optimize the overall planning policy of general outpatient services for employee medical insurance:
Downward adjustment"Threshold fee"
The minimum payment standard for general outpatient medical insurance for employees of special medical institutions (including the First Affiliated Hospital of Dalian Medical University, the Second Affiliated Hospital of Dalian Medical University, Dalian Central Hospital, and Zhongshan Hospital Affiliated to Dalian University) has been reduced from 1,000 yuan to 600 yuan
*The minimum payment standard for general outpatient medical insurance for medical institutions and **specialist employees has been reduced from 700 yuan and 500 yuan to 400 yuan respectively
The minimum payment standard for general outpatient medical insurance for employees in secondary medical institutions has been lowered from 500 yuan to 200 yuan
The minimum payment standard for general outpatient medical insurance for employees of medical institutions at level 1 and below (including psychiatric and infectious disease specialists) has been lowered from 300 yuan to 200 yuan.
Increase reimbursement rates.
*The overall reimbursement ratio of general outpatient medical insurance for employees of medical institutions has been increased from 50% to 55%.
The overall reimbursement ratio of general outpatient medical insurance for employees of secondary medical institutions (including secondary and below specialists) has been increased from 60% to 65%.
Retirees add another 5 percentage points to the above criteria.
The reimbursement ratio of special**, specialty, first-class and below, psychiatric specialists, and infectious disease specialized medical institutions remains unchanged.
Keep the cap unchanged.
In 2024, the annual payment ceiling of Dalian Employee Medical Insurance General Outpatient Coordination will remain at 120,000 yuan unchanged.
Interpretation of the New Deal. Is there a change in the 2024 annual reimbursement cap for employee medical insurance outpatient clinics?
1. What are the changes in the outpatient reimbursement policy for employees of special ** medical institutions in our city in 2024?
Answer: In 2024, the city's special ** medical institutions (including the First Affiliated Hospital of Dalian Medical University, the Second Affiliated Hospital of Dalian Medical University, Dalian Central Hospital, and Zhongshan Hospital Affiliated to Dalian University) will be reimbursed for employee medical insurance outpatient services"Threshold fee"The reimbursement ratio has been reduced from 1,000 yuan to 600 yuan, and the reimbursement ratio remains unchanged, with 50% for active employees and 55% for retired employees.
2. What are the changes in the outpatient reimbursement policy for employees of the city's leading medical institutions in 2024?
Answer: In 2024, the city's ** medical institutions will be reimbursed for employee medical insurance outpatient services"Threshold fee"The reimbursement rate has been reduced from 700 yuan to 400 yuan, and the reimbursement ratio has been increased from 50% to 55% for active employees and from 55% to 60% for retired employees.
3. What are the changes in the outpatient reimbursement policy for employees of the city's ** specialized medical institutions in 2024?
Answer: In 2024, the city's ** specialized medical institutions will be reimbursed for employee medical insurance outpatient services"Threshold fee"The reimbursement rate has been reduced from 500 yuan to 400 yuan, and the reimbursement ratio remains unchanged, with 60% for active employees and 65% for retired employees.
4. What are the changes in the outpatient reimbursement policy for employees of secondary (including secondary and below specialist) medical institutions in our city in 2024?
Answer: In 2024, the city's secondary (including secondary and below specialist) medical institutions will be reimbursed for employee medical insurance outpatient services"Threshold fee"The reimbursement rate has been reduced from 500 yuan to 200 yuan, and the reimbursement ratio has been increased from 60% to 65% for active employees and from 65% to 70% for retired employees.
5. What are the changes in the outpatient reimbursement policy for employees of first-level medical institutions in our city in 2024?
Answer: In 2024, the outpatient medical insurance reimbursement for employees of medical institutions at and below in our city (including first-level hospitals, community health service centers (stations), township health centers, etc.)."Threshold fee"The reimbursement rate has been reduced from 300 yuan to 200 yuan, and the reimbursement ratio remains unchanged, with 70% for active employees and 75% for retired employees. If you sign a contract with a family doctor to upgrade your service package and receive medical treatment at a contracted primary medical institution, it will be increased by another 10 percentage points.
6. In 2024, will there be any changes to the annual reimbursement ceiling for outpatient medical insurance for employees?
Answer: There is no change, and the annual payment ceiling of Dalian Employee Medical Insurance General Outpatient Clinic will remain at 1 in 202420,000 yuan unchanged.
7. What outpatient medical expenses can be reimbursed?
Answer: The insured person is entitled to outpatient co-ordination reimbursement treatment according to the policy for drugs, examinations, ** and other expenses within the scope of medical insurance payment incurred by the insured in the outpatient co-ordination designated hospital due to illness.
According to the Municipal Medical Insurance Bureau.