New Rules for Outpatient Reimbursement of Medical Insurance in Jilin Province in 2023

The new regulations for outpatient reimbursement of medical insurance in Jilin Province in 2023 are as follows:

1. The medical expenses above 1800 yuan can only be reimbursed after the on-the-job employees go to the hospital for emergency treatment, and the reimbursement rate is 50%;

2. Retirees under the age of 70,1.Expenses above 300 yuan can be reimbursed, and the reimbursement rate is 70%; For retirees over 70 years old, 80% of the expenses above 1300 yuan can be reimbursed.

However, in the following cases, medical insurance will not be paid:

1, see a doctor in a non-designated medical institution or buy medicine in a non-designated retail pharmacy (except emergency);

2, due to alcoholism, suicide, self-harm and other reasons to receive treatment;

3. Injuries caused by traffic accidents, medical accidents or other accidents;

4, because I fight, drug abuse or other illegal acts caused by their own injuries;

5, according to national or local regulations should be paid by individuals.

The information required for medical insurance reimbursement is as follows:

1, original ID card or social security card;

2, the original certificate of disease diagnosis issued by the designated medical institutions;

3, outpatient medical records, inspection, test results report and other original medical information;

4. Original receipt of outpatient charges of medical institutions with unified finance and taxation;

5. The detailed list of outpatient expenses printed by the hospital computer or the original payment of prescriptions issued by doctors;

6. Designated pharmacies: unified original invoices and computer-printed sales lists of taxable goods;

7. If it is an agent, you need to provide the original ID card of the agent.

To sum up, take all the above information to the relevant departments of the local social security center. Upon examination, if the information is complete and meets the requirements, it can be handled immediately. When applying for reimbursement of outpatient medical expenses, the applicant should first deduct the amount allocated to the personal account of medical insurance in this social security year, and then verify the amount to be reimbursed.

Legal basis:

Article 29 of People's Republic of China (PRC) Social Insurance Law

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.