最新发布！2024年丰县职工医保待遇
<section data-role="outer" label="edit by 135editor"><section data-support="96编辑器" data-style-id="49167" style="margin-bottom: 0px;outline: 0px;overflow: visible;visibility: visible;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;visibility: visible;"><section style="padding: 6px 30px;outline: 0px;background-image: linear-gradient(90deg, rgb(84, 210, 229), rgb(94, 225, 147));border-radius: 7px 7px 0px 0px;visibility: visible;"><section style="outline: 0px;font-size: 16px;letter-spacing: 2px;color: rgb(254, 254, 254);visibility: visible;"><p style="outline: 0px;visibility: visible;"><span style="outline: 0px;letter-spacing: 0.5px;font-size: 17px;visibility: visible;"><strong style="outline: 0px;visibility: visible;">普通门诊 （含异地就医、转诊转院备案）</strong></span></p></section></section><section style="margin-top: 5px;outline: 0px;display: flex;justify-content: flex-start;align-items: center;visibility: visible;"><section data-width="30%" style="outline: 0px;width: 144px;height: 1px;background-color: rgb(90, 218, 183);visibility: visible;"><br style="outline: 0px;visibility: visible;"/></section><section style="margin-left: 5px;outline: 0px;width: 6px;height: 6px;border-radius: 50%;background-color: rgb(90, 218, 183);visibility: visible;"><br style="outline: 0px;visibility: visible;"/></section></section></section></section><section style="margin-bottom: 0px;outline: 0px;overflow: visible;visibility: visible;"><p style="outline: 0px;text-align: center;visibility: visible;"></p><section style="outline: 0px;text-align: left;line-height: 1.6em;visibility: visible;"><span style="outline: 0px;color: rgb(0, 0, 0);visibility: visible;"><strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;letter-spacing: 0.5px;font-size: 15px;visibility: visible;">备注：</span></strong></span></section><section style="outline: 0px;text-indent: 2em;visibility: visible;"><span style="outline: 0px;font-size: 15px;visibility: visible;">1.A级、B级定点药店起付线和报销比例等同一级定点医疗机构；</span></section><section style="outline: 0px;text-indent: 2em;visibility: visible;"><span style="outline: 0px;font-size: 15px;visibility: visible;">2.C级定点药店仅享受个人账户、家庭共济和起付线；</span></section><section style="outline: 0px;text-indent: 2em;line-height: 1.6em;visibility: visible;"><span style="outline: 0px;letter-spacing: 0.5px;font-size: 15px;color: rgb(0, 0, 0);visibility: visible;">3. </span><span style="outline: 0px;letter-spacing: 0.5px;font-size: 15px;color: rgb(123, 12, 0);visibility: visible;">异地未备案门诊待遇报销比例降低20%。</span></section><section style="outline: 0px;text-indent: 2em;line-height: 1.6em;visibility: visible;"><span style="outline: 0px;color: rgb(136, 136, 136);letter-spacing: 0.5px;font-size: 15px;visibility: visible;"><br style="outline: 0px;visibility: visible;"/></span></section><section data-support="96编辑器" data-style-id="7806" style="outline: 0px;font-family: PingFang SC, system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;text-wrap: wrap;background-color: rgb(255, 255, 255);visibility: visible;"><section style="margin-right: auto;margin-left: auto;outline: 0px;visibility: visible;"><section style="padding: 2px 10px;outline: 0px;visibility: visible;"><section style="margin-right: 10px;outline: 0px;width: 50px;height: 50px;border-width: 2px;border-style: solid;border-color: rgb(139, 162, 176);border-radius: 50%;float: left;visibility: visible;"></section><section data-style="clear:none;line-height:17px;padding:0 0;font-size:12px;" style="margin: 5px;outline: 0px;visibility: visible;"><p style="outline: 0px;clear: none;font-size: 12px;line-height: 1.5em;visibility: visible;"><span style="outline: 0px;font-size: 17px;visibility: visible;"><strong style="outline: 0px;visibility: visible;"><span style="outline: 0px;letter-spacing: 0.5px;visibility: visible;color: rgb(0, 82, 255);">职工门诊案例</span></strong></span><span style="outline: 0px;letter-spacing: 0.5px;visibility: visible;"><span style="outline: 0px;font-size: 16px;visibility: visible;color: rgb(0, 82, 255);"><strong style="outline: 0px;visibility: visible;"> </strong></span><span style="outline: 0px;color: rgb(139, 162, 176);font-size: 16px;visibility: visible;"><strong style="outline: 0px;visibility: visible;"> </strong></span></span></p><p style="outline: 0px;clear: none;font-size: 12px;line-height: 1.5em;visibility: visible;"><span style="outline: 0px;color: rgb(139, 162, 176);font-size: 16px;visibility: visible;"><strong style="outline: 0px;visibility: visible;">刘某，退休职工。</strong></span></p></section></section><section style="margin: 5px;outline: 0px;border-width: initial;border-style: none;border-color: initial;visibility: visible;"><section style="margin-left: 18px;outline: 0px;width: 0px;border-bottom: 0.6em solid rgb(139, 162, 176);border-top-color: rgb(139, 162, 176);height: 10px;color: inherit;visibility: visible;border-left: 0.7em solid transparent !important;border-right: 0.7em solid transparent !important;"><br style="outline: 0px;visibility: visible;"/></section><section style="margin-top: -8px;margin-left: 18px;outline: 0px;width: 0px;border-bottom: 0.6em solid rgb(254, 254, 254);border-top-color: rgb(254, 254, 254);height: 10px;color: inherit;float: left;visibility: visible;border-left: 0.7em solid transparent !important;border-right: 0.7em solid transparent !important;"><br style="outline: 0px;visibility: visible;"/></section><section style="margin-right: auto;margin-bottom: -2px;margin-left: auto;padding: 15px;outline: 0px;text-align: center;border-width: 2px;border-style: solid;border-color: rgb(139, 162, 176);border-radius: 5px;visibility: visible;"><section style="margin-bottom: 8px;outline: 0px;border-color: rgb(139, 162, 176);text-align: justify;visibility: visible;line-height: 2em;"><span style="outline: 0px;text-align: center;font-size: 16px;letter-spacing: 0.5px;">2024年在一级医院门诊共花费3000元，其中甲类2000元，乙类10%药品950元，丙类50元。那职工医保可以报销多少？</span></section><section style="outline: 0px;text-align: justify;line-height: 2em;"><strong style="outline: 0px;"><span style="outline: 0px;font-size: 16px;letter-spacing: 0.5px;color: rgb(123, 12, 0);">一级医院门诊报销：</span></strong><span style="outline: 0px;color: rgb(0, 82, 255);font-size: 16px;letter-spacing: 0.5px;">3000元（总费用）-50元（自费费用）- 95元（先行自付950x10%）-350元（退休门诊起付线）=2505元，<span style="outline: 0px;">2505元</span>x85%=2129.25元，即本次职工医保报销2129.25元。</span></section></section></section></section></section><section style="outline: 0px;line-height: 1.6em;text-indent: 0em;"><span style="outline: 0px;color: rgb(136, 136, 136);letter-spacing: 0.5px;font-size: 15px;"></span></section><section style="outline: 0px;text-indent: 2em;"><br style="outline: 0px;"/></section></section><section data-support="96编辑器" data-style-id="49167" style="margin-bottom: 0px;outline: 0px;overflow: visible;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;"><section style="padding: 6px 30px;outline: 0px;background-image: linear-gradient(90deg, rgb(84, 210, 229), rgb(94, 225, 147));border-radius: 7px 7px 0px 0px;"><section style="outline: 0px;font-size: 16px;letter-spacing: 2px;color: rgb(254, 254, 254);"><p style="outline: 0px;"><span style="outline: 0px;font-size: 17px;letter-spacing: normal;"><strong style="outline: 0px;">普通住院、门特 （含异地就医备案）</strong></span><span style="outline: 0px;letter-spacing: 0.5px;font-size: 17px;"></span></p></section></section><section style="margin-top: 5px;outline: 0px;display: flex;justify-content: flex-start;align-items: center;"><section data-width="30%" style="outline: 0px;width: 144px;height: 1px;background-color: rgb(90, 218, 183);"><br style="outline: 0px;"/></section><section style="margin-left: 5px;outline: 0px;width: 6px;height: 6px;border-radius: 50%;background-color: rgb(90, 218, 183);"><br style="outline: 0px;"/></section></section></section></section><section style="margin-bottom: 0px;outline: 0px;overflow: visible;"><p style="outline: 0px;text-align: center;"></p><p style="outline: 0px;line-height: 1.6em;"><span style="outline: 0px;color: rgb(0, 0, 0);"><strong style="outline: 0px;"><span style="outline: 0px;font-size: 15px;letter-spacing: 0.5px;">备注：</span></strong></span></p><p style="outline: 0px;text-indent: 2em;line-height: 1.6em;"><span style="outline: 0px;color: rgb(0, 0, 0);font-size: 15px;letter-spacing: 0.034em;">1.多次住院起付线依次递减 100元，设置下限（在职三级300元、二级200元、一级100元，退休按照50%执行）；</span><br style="outline: 0px;"/></p><section style="outline: 0px;text-indent: 2em;"><span style="outline: 0px;color: rgb(0, 0, 0);font-size: 15px;letter-spacing: 0.034em;">2.门特待遇可扩大到A级药店按照三级医疗机构享受；</span><br style="outline: 0px;"/></section><section style="outline: 0px;text-indent: 2em;"><span style="outline: 0px;color: rgb(123, 12, 0);font-size: 15px;letter-spacing: 0.034em;">3.<span style="outline: 0px;letter-spacing: 0.578px;">异地未备案住院起付标准</span>每次为在职1500元，退休750元；</span></section><section style="outline: 0px;text-indent: 2em;"><span style="outline: 0px;font-size: 15px;color: rgb(123, 12, 0);">4.异地未备案住院、门特待遇报销比例降低20%，且不享受大病保险待遇。</span></section><section style="outline: 0px;text-indent: 2em;"><br style="outline: 0px;"/></section><p style="outline: 0px;text-indent: 2em;line-height: 1.6em;"><br style="outline: 0px;"/></p></section><section data-support="96编辑器" data-style-id="49167" style="margin-bottom: 0px;outline: 0px;overflow: visible;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;"><section style="padding: 6px 30px;outline: 0px;background-image: linear-gradient(90deg, rgb(84, 210, 229), rgb(94, 225, 147));border-radius: 7px 7px 0px 0px;"><section style="outline: 0px;font-size: 16px;letter-spacing: 2px;color: rgb(254, 254, 254);"><p style="outline: 0px;"><span style="outline: 0px;font-size: 17px;"><strong style="outline: 0px;">转诊转院住院</strong></span></p></section></section><section style="margin-top: 5px;outline: 0px;display: flex;justify-content: flex-start;align-items: center;"><section data-width="30%" style="outline: 0px;width: 144px;height: 1px;background-color: rgb(90, 218, 183);"><br style="outline: 0px;"/></section><section style="margin-left: 5px;outline: 0px;width: 6px;height: 6px;border-radius: 50%;background-color: rgb(90, 218, 183);"><br style="outline: 0px;"/></section></section></section></section><section style="margin-bottom: 0px;outline: 0px;overflow: visible;"><p style="outline: 0px;text-align: center;"><span style="outline: 0px;font-size: var(--articleFontsize);letter-spacing: 0.034em;"></span></p></section><section style="margin-bottom: 0px;outline: 0px;overflow: visible;"><p style="outline: 0px;"><span style="outline: 0px;color: rgb(0, 0, 0);"><strong style="outline: 0px;color: rgb(136, 136, 136);font-family: PingFang SC, system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;font-size: 14px;letter-spacing: 0.544px;text-align: left;text-wrap: wrap;background-color: rgb(255, 255, 255);">提示：</strong><strong style="outline: 0px;color: rgb(136, 136, 136);font-family: PingFang SC, system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;font-size: 14px;letter-spacing: 0.544px;text-align: left;background-color: rgb(255, 255, 255);">同一统筹年度内，政策范围内医疗费用（含普通门诊、普通住院、门特、转诊转院住院、异地未备案）的最高支付限额为40万元。</strong></span></p></section><p style="margin-bottom: 0px;outline: 0px;"><br style="outline: 0px;"/></p><section data-support="96编辑器" data-style-id="49167" style="margin-bottom: 0px;outline: 0px;overflow: visible;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;"><section style="padding: 6px 30px;outline: 0px;background-image: linear-gradient(90deg, rgb(84, 210, 229), rgb(94, 225, 147));border-radius: 7px 7px 0px 0px;"><section style="outline: 0px;font-size: 16px;letter-spacing: 2px;color: rgb(254, 254, 254);"><p style="outline: 0px;"><span style="outline: 0px;font-size: 17px;letter-spacing: 0.5px;"><strong style="outline: 0px;">大病保险（含门特和住院）</strong></span></p></section></section><section style="margin-top: 5px;outline: 0px;display: flex;justify-content: flex-start;align-items: center;"><section data-width="30%" style="outline: 0px;width: 144px;height: 1px;background-color: rgb(90, 218, 183);"><br style="outline: 0px;"/></section><section style="margin-left: 5px;outline: 0px;width: 6px;height: 6px;border-radius: 50%;background-color: rgb(90, 218, 183);"><br style="outline: 0px;"/></section></section></section></section><section style="margin-bottom: 0px;outline: 0px;overflow: visible;"><p style="outline: 0px;text-align: center;"></p><p style="outline: 0px;"><span style="outline: 0px;color: rgb(0, 0, 0);"><strong style="outline: 0px;"><span style="outline: 0px;font-size: 15px;">备注：</span></strong><span style="outline: 0px;font-size: 15px;">低保、特困、重残、退休人员，报销比例提高5%。</span></span></p><p style="outline: 0px;"><span style="outline: 0px;font-size: 15px;color: rgb(136, 136, 136);"><br style="outline: 0px;"/></span></p></section><section data-support="96编辑器" data-style-id="7806" style="margin-bottom: 0px;outline: 0px;text-wrap: wrap;font-family: PingFang SC, system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;background-color: rgb(255, 255, 255);visibility: visible;"><section style="margin-right: auto;margin-left: auto;outline: 0px;visibility: visible;"><section style="padding: 2px 10px;outline: 0px;visibility: visible;"><section style="margin-right: 10px;outline: 0px;width: 50px;height: 50px;border-width: 2px;border-style: solid;border-color: rgb(139, 162, 176);border-radius: 50%;float: left;visibility: visible;"></section><section data-style="clear:none;line-height:17px;padding:0 0;font-size:12px;" style="margin: 5px;outline: 0px;visibility: visible;"><p style="outline: 0px;clear: none;font-size: 12px;line-height: 1.5em;visibility: visible;"><span style="outline: 0px;font-size: 17px;"><strong style="outline: 0px;"><span style="outline: 0px;letter-spacing: 0.5px;visibility: visible;color: rgb(0, 82, 255);">职工住院案例</span></strong></span><span style="outline: 0px;letter-spacing: 0.5px;"><span style="outline: 0px;font-size: 16px;visibility: visible;color: rgb(0, 82, 255);"><strong style="outline: 0px;visibility: visible;"> </strong></span><span style="outline: 0px;color: rgb(139, 162, 176);font-size: 16px;visibility: visible;"><strong style="outline: 0px;visibility: visible;"> </strong></span></span></p><p style="outline: 0px;clear: none;font-size: 12px;line-height: 1.5em;visibility: visible;"><span style="outline: 0px;color: rgb(139, 162, 176);font-size: 16px;visibility: visible;"><strong style="outline: 0px;visibility: visible;">张某，在职职工。</strong></span></p></section></section><section style="margin: 5px;outline: 0px;border-width: initial;border-style: none;border-color: initial;visibility: visible;"><section style="margin-left: 18px;outline: 0px;width: 0px;border-bottom: 0.6em solid rgb(139, 162, 176);border-top-color: rgb(139, 162, 176);height: 10px;color: inherit;visibility: visible;border-left: 0.7em solid transparent !important;border-right: 0.7em solid transparent !important;"><br style="outline: 0px;visibility: visible;"/></section><section style="margin-top: -8px;margin-left: 18px;outline: 0px;width: 0px;border-bottom: 0.6em solid rgb(254, 254, 254);border-top-color: rgb(254, 254, 254);height: 10px;color: inherit;float: left;visibility: visible;border-left: 0.7em solid transparent !important;border-right: 0.7em solid transparent !important;"><br style="outline: 0px;visibility: visible;"/></section><section style="margin-right: auto;margin-bottom: -2px;margin-left: auto;padding: 15px;outline: 0px;text-align: center;border-width: 2px;border-style: solid;border-color: rgb(139, 162, 176);border-radius: 5px;visibility: visible;"><section style="margin-bottom: 8px;outline: 0px;border-color: rgb(139, 162, 176);text-align: justify;visibility: visible;line-height: 2em;"><span style="outline: 0px;font-size: 16px;letter-spacing: 0.5px;">2024年2月在三级医院第一次住院共15天，花费200000元，其中甲类197800元，乙类25%药品2000元，丙类200元，那职工医保可以报销多少呢？</span></section><section style="outline: 0px;text-align: justify;line-height: 2em;"><strong style="outline: 0px;"><span style="outline: 0px;font-size: 16px;letter-spacing: 0.5px;color: rgb(123, 12, 0);">三级医院住院报销：</span></strong><span style="outline: 0px;color: rgb(0, 82, 255);font-size: 16px;letter-spacing: 0.5px;">200000元（总费用）-500元（先行自付2000x25%）-200元（个人自费）-1000元（在职三级医院起付线）=198300<span style="outline: 0px;">元，<span style="outline: 0px;">198300元</span></span>x86%=170538元；</span></section><section style="outline: 0px;text-align: justify;line-height: 2em;"><strong style="outline: 0px;"><span style="outline: 0px;font-size: 16px;letter-spacing: 0.5px;color: rgb(123, 12, 0);">职工大病保险报销：</span></strong><span style="outline: 0px;color: rgb(0, 82, 255);font-size: 16px;letter-spacing: 0.5px;">200000元（总费用）-200元（自费费用）-170538元（统筹报销）-18000元（大病保险起付线）=11262<span style="outline: 0px;">元，<span style="outline: 0px;">11262元</span></span>x70%=7883.4元。</span></section><section style="outline: 0px;text-align: justify;line-height: 2em;"><span style="outline: 0px;color: rgb(123, 12, 0);"><strong style="outline: 0px;"><span style="outline: 0px;font-size: 16px;letter-spacing: 0.5px;">本次职工医保总报销：</span></strong></span><span style="outline: 0px;color: rgb(0, 82, 255);font-size: 16px;letter-spacing: 0.5px;">170538元+7883.4元=178421.4元。</span></section></section></section></section></section><p style="margin-bottom: 0px;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><br style="outline: 0px;"/></p></section><p><section data-role="outer" label="edit by 135editor"><section style="text-align: right;outline: 0px;letter-spacing: 0.544px;background-color: rgb(255, 255, 255);font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;margin-bottom: 0px;"></section><section style="text-align: justify;outline: 0px;letter-spacing: 0.544px;background-color: rgb(255, 255, 255);font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;margin-left: 8px;margin-right: 8px;"><span style="color:#888888;"><span style="font-size: 14px;caret-color: rgb(255, 0, 0);">来源</span></span><span style="color: rgb(136, 136, 136);font-size: 14px;caret-color: rgb(255, 0, 0);"> | 徐州医保</span></section></section></p><link rel="stylesheet" href="//bbs.221700.com/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_Mnz" id="wcn_editor_css"/> 真不错 还得是职工医保 感谢楼主分享！ 感谢分享 感谢分享 感谢分享 谢谢分享！ 谢谢分享
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