In 2025, the outpatient reimbursement limit for flexible employment medical insurance in Quzhou, Zhejiang consists of ordinary outpatient and chronic disease outpatient aspects. The maximum payment limit for ordinary outpatient services is 1800 yuan, and for chronic disease outpatient services, it is 2000 yuan.
Ordinary Outpatient:
- Deductible and Maximum Limit: The starting payment standard is 100 yuan, and the maximum payment limit is 1800 yuan. Only the medical expenses above the starting payment standard and within the maximum payment limit can be reimbursed.
- Reimbursement Ratio: For the part between the deductible and the maximum payment limit, in general, if it is in a secondary or lower - level medical institution (including private medical institutions) that purchases from the drug procurement platform and implements zero - mark - up drug sales, the reimbursement ratio of the fund will increase by 10 percentage points. For non - such secondary or lower - level medical institutions, the reimbursement ratio is 40%. In secondary - level medical institutions, it is 20%, and in tertiary - level medical institutions, it is 20%. Additionally, for three types of specialized diseases (psychiatric, pediatric, and traditional Chinese medicine) in general outpatient clinics in the co - ordination area, the fund payment in secondary - level designated medical institutions increases by 5 percentage points, and in tertiary - level designated medical institutions, it increases by 10 percentage points.
Chronic Disease Outpatient:
- Deductible and Maximum Limit: There is no deductible, and the maximum payment limit is 2000 yuan.
- Reimbursement Ratio: The fund pays 60% (for tuberculosis outpatient, the fund pays 70%).
It should be noted that specific reimbursement policies may be adjusted according to actual situations. It is recommended that flexible employment personnel consult the local medical insurance department in time to understand the latest and most accurate information.