In 2025, the reimbursement ratio of flexible employment medical insurance in Guilin, Guangxi varies depending on different situations. For outpatient services: When visiting first-level and below designated medical institutions, the reimbursement ratio for on-the-job individuals is 60%, and for retirees, it is 65%. At second-level designated medical institutions, on-the-job individuals can be reimbursed at a ratio of 55%, and retirees at 60%. For third-level designated medical institutions, the reimbursement ratio for on-the-job is 50%, and for retirees, it is 55%. For inpatient services: In the first-tier payment level of flexible employment, the on-the-job reimbursement ratio is 90%, and the retiree reimbursement ratio is 95%. In the second-tier payment level of flexible employment, the on-the-job reimbursement ratio is 85%, and the retiree reimbursement ratio is 90%.
Here are some key points to note:
- Outpatient reimbursement details: There is a set reimbursement ceiling. For example, for on-the-job individuals, the annual maximum reimbursement limit for outpatient services is 1200 yuan, and for retirees, it is 1800 yuan. Also, there is a deductible. In an insured year, the deductible for outpatient medical expenses is 600 yuan. Only the expenses exceeding this amount can be reimbursed according to the corresponding ratio.
- Inpatient reimbursement details: There are also differences in reimbursement ratios based on hospital levels. Generally, at third-level hospitals, the reimbursement ratio ranges from 85% to 95%; at second-level hospitals, it ranges from 87% to 97%; and at community hospitals, it ranges from 90% to 97%. There are also regulations on the deductible for hospitalization. The deductible for hospitalization is 1500 yuan for second-level hospitals and 3000 yuan for third-level hospitals. In addition, there is an annual maximum reimbursement limit. For example, the annual maximum reimbursement limit for basic medical insurance is 300,000 yuan.
- Payment level impact: Flexible employment medical insurance in Guilin has different payment levels, and the reimbursement ratios also vary accordingly. As mentioned above, in different payment levels, the reimbursement ratios for on-the-job and retirees during hospitalization are different.
In conclusion, when using flexible employment medical insurance in Guilin for reimbursement, it is necessary to clearly understand the specific regulations regarding outpatient and inpatient services, including reimbursement ratios, deductibles, and reimbursement limits, so as to better enjoy medical insurance benefits. It is also recommended to consult the local medical insurance department for the most accurate and up-to-date information.