2025江苏泰州大病医保住院报销比例

有家健康网 2025-05-07阅读量：5814

In 2025, the critical illness insurance inpatient reimbursement ratio in Taizhou, Jiangsu varies depending on different situations. For urban and rural residents, if the self - paid compliance cost within 15,000 - 100,000 yuan (inclusive) in a settlement year, the reimbursement ratio is 60%, and for the part above 100,000 yuan, the reimbursement ratio is 70%. For the disadvantaged groups, if the cost is 5,000 - 100,000 yuan (inclusive), the reimbursement ratio is 70%, and for the part above 100,000 yuan, the reimbursement ratio is 80%. For urban employees, if the self - paid compliance cost is 10,000 - 100,000 yuan, the reimbursement ratio is 70%, and for the part above 100,000 yuan, the reimbursement ratio is 80%. For the disadvantaged groups participating in employee medical insurance, the critical illness insurance deductible standard is reduced from 10,000 yuan to 5,000 yuan, and the segmented compensation standard is increased by 10 percentage points on the original basis.

1. For urban and rural residents:

• General situation: The deductible standard for critical illness insurance is 15,000 yuan. For the part of the policy - compliant self - paid medical expenses within 15,000 - 100,000 yuan (inclusive) in a settlement year, the reimbursement ratio is 60%, and for the part above 100,000 yuan, the reimbursement ratio is 70%.

• For disadvantaged groups: The deductible standard is 5,000 yuan. For the part of 5,000 - 100,000 yuan (inclusive) of the self - paid compliance cost, the reimbursement ratio is 70%, and for the part above 100,000 yuan, the reimbursement ratio is 80%. The disadvantaged groups here mainly refer to those defined in relevant policies, such as low - income families, families with special difficulties, etc.

2. For urban employees:

• General situation: The deductible standard has been reduced from 15,000 yuan to 10,000 yuan. For the part of the self - paid compliance cost of 10,000 - 100,000 yuan, the reimbursement ratio is 70%, and for the part above 100,000 yuan, the reimbursement ratio is 80%.

• For disadvantaged groups: The critical illness insurance deductible standard is reduced from 10,000 yuan to 5,000 yuan. And the segmented compensation standard is increased by 10 percentage points on the original basis. That is, for the part of 5,000 - 100,000 yuan, the reimbursement ratio is 80% (70% + 10%), and for the part above 100,000 yuan, the reimbursement ratio is 90% (80%+10%).

It should be noted that to enjoy the above - mentioned critical illness insurance inpatient reimbursement, it is necessary to meet the relevant regulations of the medical insurance, such as seeking medical treatment at designated medical institutions, and the medical expenses should be within the scope of compliance as specified by the policy.