渭南人速看！医保报销标准全解读！掌握这些，医保多报销→
<div class="wx_rich_media_content" id="jsWxContainer"><p style="outline: 0px; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; visibility: visible; margin-bottom: 16px;"><span style="font-size: 16px; letter-spacing: 0.544px; color: rgb(68, 68, 68);">近期，多地医保局发文明确了医保缴费年限核定标准。</span></p><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="outline: 0px;">医保政策与每个人息息相关，但在实际运用过程中，您是不是总不清楚医保报销范围和报销比例？别担心！这篇“医保报销全解读”手把手教您计算，包教包会！</p><p style="outline: 0px;"><br style="outline: 0px;"></p></section><section powered-by="xiumi.us" style="margin-top: 25px; margin-bottom: 10px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px; justify-content: flex-start; display: flex; flex-flow: row;"><section style="outline: 0px;display: inline-block;width: auto;vertical-align: top;background-color: rgba(109, 178, 224, 0.3);min-width: 10%;flex: 0 0 auto;height: auto;align-self: flex-start;"><section powered-by="xiumi.us" style="margin-top: -9px;margin-bottom: 5px;outline: 0px;display: flex;flex-flow: row;justify-content: flex-start;"><section style="margin-top: 5px;margin-left: 7px;outline: 0px;display: inline-block;vertical-align: top;width: auto;flex: 0 0 0%;height: auto;line-height: 0;align-self: flex-start;border-width: 0px;"><section powered-by="xiumi.us" style="outline: 0px;text-align: center;"><section style="outline: 0px;display: inline-block;width: 2px;height: 10px;vertical-align: top;overflow: hidden;background-color: rgb(109, 178, 224);"><svg viewBox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section><section powered-by="xiumi.us" style="margin-top: -6px;margin-bottom: 4px;outline: 0px;text-align: center;"><section style="outline: 0px;display: inline-block;width: 10px;height: 2px;vertical-align: top;overflow: hidden;background-color: rgb(109, 178, 224);"><svg viewBox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section></section><section style="margin-left: 4px;outline: 0px;display: inline-block;vertical-align: top;width: auto;min-width: 10%;flex: 0 0 auto;height: auto;line-height: 0;border-width: 0px;"><section powered-by="xiumi.us" style="margin-top: -4px;outline: 0px;text-align: center;"><section style="outline: 0px;display: inline-block;width: 9px;height: 9px;vertical-align: top;overflow: hidden;border-width: 2px;border-radius: 47px;border-style: solid;border-color: rgb(109, 178, 224);"><svg viewBox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section></section><section style="outline: 0px;display: inline-block;vertical-align: top;width: auto;min-width: 10%;flex: 0 0 auto;height: auto;"><section powered-by="xiumi.us" style="outline: 0px;"><section style="padding-right: 13px;padding-left: 13px;outline: 0px;color: rgb(30, 30, 30);font-family: Optima-Regular, PingFangTC-light;line-height: 1;letter-spacing: 0px;text-align: justify;"><p style="outline: 0px;"><strong style="outline: 0px;">知识点速览</strong></p></section></section></section></section></section></section><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="margin-bottom: 5px;outline: 0px;text-align: center;">影响报销的四大因素：</p><p style="margin-bottom: 5px;outline: 0px;text-align: center;">1.医保“三大目录”</p><p style="margin-bottom: 5px;outline: 0px;text-align: center;">2.起付线</p><p style="margin-bottom: 5px;outline: 0px;text-align: center;">3.封顶线</p><p style="outline: 0px;text-align: center;">4.报销比例</p></section><section powered-by="xiumi.us" style="margin-top: 10px; margin-bottom: 10px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px; text-align: center;"><section data-lazy-bgimg="https://mmbiz.qpic.cn/sz_mmbiz_png/AghtoUsPlpyKeAvMVprJQVLkEWfJaQIOniaW5eDxLcUf0xGKfpicALJByiaAKnnGD1icWFLUsCfswicQP6ITblk59TQ/640?wx_fmt=png&from=appmsg" data-fail="0" style="padding: 5px 15px;outline: 0px;display: inline-block;min-width: 10%;vertical-align: top;box-shadow: rgba(11, 98, 144, 0.61) 0px 0px 4px inset;background-position: 0% 0%;background-repeat: repeat;background-size: auto;background-attachment: scroll;border-width: 4px;border-radius: 20px;border-style: solid;border-color: rgb(234, 247, 255);overflow: hidden;<a href=" https:="" mmbiz.qpic.cn="" sz_mmbiz_png="" aghtousplpykeavmvprjqvlkewfjaqioniaw5edxlcuf0xgkfpicaljbyiaaknngd1icwfluscfswicqp6itblk59tq="" 640?wx_fmt="png""" target="_blank"><section powered-by="xiumi.us" style="outline: 0px;color: rgb(1, 134, 193);text-align: left;"><p style="outline: 0px;"><strong style="outline: 0px;">什么是医保“三大目录”？</strong></p></section></section></section><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="outline: 0px;">医保“三大目录”是医保药品目录、诊疗项目目录和医疗服务设施范围目录的统称，也是基本医疗保险的保障范围。参与了基本医疗保险的人，只有在定点医院发生符合三大目录的相关诊疗费用才能予以报销。</p><p style="outline: 0px;text-align: center;margin-top: 16px;margin-bottom: 16px;"><span class="wxart_image" wx-style="display:inline-block;outline: 0px;visibility: visible !important;width: 527px !important;"></span></p></section><section powered-by="xiumi.us" style="margin-top: 10px; margin-bottom: 10px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px; text-align: center;"><section data-lazy-bgimg="https://mmbiz.qpic.cn/sz_mmbiz_png/AghtoUsPlpyKeAvMVprJQVLkEWfJaQIOniaW5eDxLcUf0xGKfpicALJByiaAKnnGD1icWFLUsCfswicQP6ITblk59TQ/640?wx_fmt=png&from=appmsg" data-fail="0" style="padding: 5px 15px;outline: 0px;display: inline-block;min-width: 10%;vertical-align: top;box-shadow: rgba(11, 98, 144, 0.61) 0px 0px 4px inset;background-position: 0% 0%;background-repeat: repeat;background-size: auto;background-attachment: scroll;border-width: 4px;border-radius: 20px;border-style: solid;border-color: rgb(234, 247, 255);overflow: hidden;<a href=" https:="" mmbiz.qpic.cn="" sz_mmbiz_png="" aghtousplpykeavmvprjqvlkewfjaqioniaw5edxlcuf0xgkfpicaljbyiaaknngd1icwfluscfswicqp6itblk59tq="" 640?wx_fmt="png""" target="_blank">https://mmbiz.qpic.cn/sz_mmbiz_p ... 40?wx_fmt=png");"><section powered-by="xiumi.us" style="outline: 0px;color: rgb(1, 134, 193);text-align: left;"><p style="outline: 0px;"><strong style="outline: 0px;">“三大目录”具体指什么？</strong></p></section></section></section><section powered-by="xiumi.us" style="margin-top: 10px; margin-bottom: 15px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px; display: flex; flex-flow: row; justify-content: flex-start;"><section style="outline: 0px;display: inline-block;vertical-align: bottom;width: auto;flex: 0 0 0%;height: auto;align-self: flex-end;"><section powered-by="xiumi.us" style="outline: 0px;text-align: center;"><section style="outline: 0px;display: inline-block;width: 28px;height: 28px;vertical-align: top;overflow: hidden;background-color: rgb(109, 178, 224);"><svg viewBox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section></section><section style="outline: 0px;display: inline-block;vertical-align: bottom;width: auto;flex: 0 0 0%;height: auto;align-self: flex-end;line-height: 0;"><section powered-by="xiumi.us" style="margin-bottom: -10px;outline: 0px;transform: translate3d(-10px, 0px, 0px);"><section style="outline: 0px;display: inline-block;width: 18px;height: 18px;vertical-align: top;overflow: hidden;background-color: rgb(207, 244, 234);border-width: 0px;"><svg viewBox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section></section><section style="outline: 0px;display: inline-block;vertical-align: bottom;width: auto;min-width: 10%;flex: 0 0 auto;height: auto;align-self: flex-end;"><section powered-by="xiumi.us" style="outline: 0px;color: rgb(62, 62, 62);letter-spacing: 0px;"><p style="outline: 0px;"><strong style="outline: 0px;">01、医保药品目录</strong></p></section></section><section style="margin-left: 10px;outline: 0px;display: inline-block;vertical-align: middle;width: auto;align-self: center;background-color: rgba(109, 178, 224, 0.11);flex: 100 100 0%;height: auto;"><section powered-by="xiumi.us" style="outline: 0px;color: rgb(255, 255, 255);line-height: 1;letter-spacing: 0px;text-align: justify;"><p style="outline: 0px;"><br style="outline: 0px;"></p></section></section></section><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="outline: 0px;">基本医疗保险药品目录，是医疗、工伤、生育保险支付药品费用的政策依据和标准。医保药品是指在国家基本药物的基础上选择治疗必需、价格便宜、治疗效果好的药品。纳入基本医疗保险给付范围内的药品，分为甲类和乙类两种。</p><p style="outline: 0px;"><br style="outline: 0px;"></p><p style="outline: 0px;"><strong style="outline: 0px;"><span style="outline: 0px;color: rgb(61, 170, 214);">甲类药品(自付比例0%)：</span></strong>参保人使用这类药品时，可以全额纳入报销范围，之后按照报销比例进行报销。</p><p style="outline: 0px;"><br style="outline: 0px;"></p><p style="outline: 0px;"><span style="outline: 0px;color: rgb(61, 170, 214);"><strong style="outline: 0px;">乙类药品：</strong></span>与甲类药品不同，若参保人使用了乙类药品，此类药品需个人负担一定的比例费用，剩下的部分纳入报销范围，按规定比例报销。</p><p style="outline: 0px;"><br style="outline: 0px;"></p><p style="outline: 0px;">按照《基本医疗保险用药管理暂行办法》(国家医疗保障局第1号令)规定，以下药品不纳入《药品目录》：</p><section style="margin-top: 8px;outline: 0px;">1.主要起滋补作用的药品；</section><section style="margin-top: 8px;outline: 0px;">2.含国家珍贵、濒危野生动植物药材的药品；</section><section style="margin-top: 8px;outline: 0px;">3.保健药品；</section><section style="margin-top: 8px;outline: 0px;">4.预防性疫苗和避孕药品；</section><section style="margin-top: 8px;outline: 0px;">5.主要起增强性功能、治疗脱发、减肥、美容、戒烟、戒酒等作用的药品；</section><section style="margin-top: 8px;outline: 0px;">6.因被纳入诊疗项目等原因，无法单独收费的药品；</section><section style="margin-top: 8px;outline: 0px;">7.酒制剂、茶制剂，各类果味制剂(特别情况下的儿童用药除外)，口腔含服剂和口服泡腾剂(特别规定情形的除外)等；</section><section style="margin-top: 8px;outline: 0px;">8.其他不符合基本医疗保险用药规定的药品。</section><p style="outline: 0px;"><br style="outline: 0px;"></p></section><section powered-by="xiumi.us" style="margin-top: 10px; margin-bottom: 15px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px; display: flex; flex-flow: row; justify-content: flex-start;"><section style="outline: 0px;display: inline-block;vertical-align: bottom;width: auto;flex: 0 0 0%;height: auto;align-self: flex-end;"><section powered-by="xiumi.us" style="outline: 0px;text-align: center;"><section style="outline: 0px;display: inline-block;width: 28px;height: 28px;vertical-align: top;overflow: hidden;background-color: rgb(109, 178, 224);"><svg viewBox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section></section><section style="outline: 0px;display: inline-block;vertical-align: bottom;width: auto;flex: 0 0 0%;height: auto;align-self: flex-end;line-height: 0;"><section powered-by="xiumi.us" style="margin-bottom: -10px;outline: 0px;transform: translate3d(-10px, 0px, 0px);"><section style="outline: 0px;display: inline-block;width: 18px;height: 18px;vertical-align: top;overflow: hidden;background-color: rgb(207, 244, 234);border-width: 0px;"><svg viewBox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section></section><section style="outline: 0px;display: inline-block;width: auto;min-width: 10%;flex: 0 0 auto;height: auto;vertical-align: bottom;align-self: flex-end;"><section powered-by="xiumi.us" style="outline: 0px;color: rgb(62, 62, 62);letter-spacing: 0px;"><p style="outline: 0px;"><strong style="outline: 0px;">02、诊疗项目目录</strong></p></section></section><section style="margin-left: 10px;outline: 0px;display: inline-block;vertical-align: middle;width: auto;align-self: center;background-color: rgba(109, 178, 224, 0.11);flex: 100 100 0%;height: auto;"><section powered-by="xiumi.us" style="outline: 0px;color: rgb(255, 255, 255);line-height: 1;letter-spacing: 0px;text-align: justify;"><p style="outline: 0px;"><br style="outline: 0px;"></p></section></section></section><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="outline: 0px;">诊疗项目目录是指临床诊疗必需、安全有效、费用适宜且由物价部门制定了收费标准的诊疗项目。</p><p style="outline: 0px;"><br style="outline: 0px;"></p><p style="outline: 0px;">通过这个目录，我们可以查看哪些医疗项目可以进行报销，哪些不能，如整容项目、美容项目等都是不在医保报销范围内的。</p><p style="outline: 0px;"><br style="outline: 0px;"></p></section><section powered-by="xiumi.us" style="margin-top: 10px; margin-bottom: 15px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px; display: flex; flex-flow: row; justify-content: flex-start;"><section style="outline: 0px;display: inline-block;vertical-align: bottom;width: auto;flex: 0 0 0%;height: auto;align-self: flex-end;"><section powered-by="xiumi.us" style="outline: 0px;text-align: center;"><section style="outline: 0px;display: inline-block;width: 28px;height: 28px;vertical-align: top;overflow: hidden;background-color: rgb(109, 178, 224);"><svg viewBox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section></section><section style="outline: 0px;display: inline-block;vertical-align: bottom;width: auto;flex: 0 0 0%;height: auto;align-self: flex-end;line-height: 0;"><section powered-by="xiumi.us" style="margin-bottom: -10px;outline: 0px;transform: translate3d(-10px, 0px, 0px);"><section style="outline: 0px;display: inline-block;width: 18px;height: 18px;vertical-align: top;overflow: hidden;background-color: rgb(207, 244, 234);border-width: 0px;"><svg viewBox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section></section><section style="outline: 0px;display: inline-block;vertical-align: bottom;width: auto;min-width: 10%;flex: 0 0 auto;height: auto;align-self: flex-end;"><section powered-by="xiumi.us" style="outline: 0px;color: rgb(62, 62, 62);letter-spacing: 0px;"><p style="outline: 0px;"><strong style="outline: 0px;">03、医疗服务设施目录</strong></p></section></section><section style="margin-left: 10px;outline: 0px;display: inline-block;vertical-align: middle;width: auto;align-self: center;background-color: rgba(109, 178, 224, 0.11);flex: 100 100 0%;height: auto;"><section powered-by="xiumi.us" style="outline: 0px;color: rgb(255, 255, 255);line-height: 1;letter-spacing: 0px;text-align: justify;"><p style="outline: 0px;"><br style="outline: 0px;"></p></section></section></section><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="outline: 0px;margin-bottom: 16px;">医疗服务设施目录是指定点医疗机构提供的，在治疗时所选择的、必须的、适量的医疗服务设施和环境标准目录。主要包括住院床位费、门急诊费、留观床位费；不予支付的有转诊交通费，急救车费、空调费、膳食费等等。</p><p style="margin-top: 8px;margin-bottom: 8px;outline: 0px;text-align: center;"><span class="wxart_image" wx-style="display:inline-block;outline: 0px;visibility: visible !important;width: 127px !important;"></span></p></section><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px; text-align: center;"><p style="margin-bottom: 5px;outline: 0px;">简单来说</p><p style="margin-bottom: 5px;outline: 0px;">在三大目录内的费用</p><p style="margin-bottom: 5px;outline: 0px;">可以进入报销计算</p><p style="outline: 0px;">那是不是只要符合医保“三大目录”费用就可以全报？</p></section><p powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><br style="outline: 0px;"></p><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="outline: 0px;">除了需要符合“三大目录”之外，医疗保险报销费用还有“起付线”与“封顶线”，“起付线”标准以上的费用才会报销。同时，报销的费用也不会超过“封顶线”。</p><p style="outline: 0px;"><br style="outline: 0px;"></p></section><section powered-by="xiumi.us" style="margin-top: 10px; margin-bottom: 10px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><section style="padding-right: 2px;outline: 0px;display: inline-block;vertical-align: middle;border-right: 2px solid rgb(203, 234, 255);border-top-color: rgb(203, 234, 255);border-bottom-color: rgb(203, 234, 255);border-left-color: rgb(203, 234, 255);"><section style="padding-right: 3px;outline: 0px;border-right: 3px solid rgb(203, 234, 255);border-top-color: rgb(203, 234, 255);border-bottom-color: rgb(203, 234, 255);border-left-color: rgb(203, 234, 255);"><section style="padding-right: 5px;padding-left: 5px;outline: 0px;background-color: rgb(203, 234, 255);color: rgb(30, 30, 30);"><p style="outline: 0px;"><strong style="outline: 0px;">医保“起付线”</strong></p></section></section></section></section><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="outline: 0px;">起付线也称“起付标准”，是指参保人在享受医疗费用报销之前需要自己先行支付的费用额度。在起付线以下的医疗费用，医疗保险统筹基金不予支付。<br style="outline: 0px;"></p><p style="outline: 0px;"><br style="outline: 0px;"></p></section><section powered-by="xiumi.us" style="margin-top: 10px; margin-bottom: 10px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><section style="padding-right: 2px;outline: 0px;display: inline-block;vertical-align: middle;border-right: 2px solid rgb(203, 234, 255);border-top-color: rgb(203, 234, 255);border-bottom-color: rgb(203, 234, 255);border-left-color: rgb(203, 234, 255);"><section style="padding-right: 3px;outline: 0px;border-right: 3px solid rgb(203, 234, 255);border-top-color: rgb(203, 234, 255);border-bottom-color: rgb(203, 234, 255);border-left-color: rgb(203, 234, 255);"><section style="padding-right: 5px;padding-left: 5px;outline: 0px;background-color: rgb(203, 234, 255);color: rgb(30, 30, 30);"><p style="outline: 0px;"><strong style="outline: 0px;">医保“封顶线”</strong></p></section></section></section></section><p powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;">封顶线是医保基金的“最高支付额度”，即参保人在一年度内累计能从医保基金里获得报销的最高限额。超出最高限额的医疗费用，医疗保险基金也不予支付。<br style="outline: 0px;"></p><p powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><br style="outline: 0px;"></p><section powered-by="xiumi.us" style="margin-top: 10px; margin-bottom: 10px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><section style="padding-right: 2px;outline: 0px;display: inline-block;vertical-align: middle;border-right: 2px solid rgb(203, 234, 255);border-top-color: rgb(203, 234, 255);border-bottom-color: rgb(203, 234, 255);border-left-color: rgb(203, 234, 255);"><section style="padding-right: 3px;outline: 0px;border-right: 3px solid rgb(203, 234, 255);border-top-color: rgb(203, 234, 255);border-bottom-color: rgb(203, 234, 255);border-left-color: rgb(203, 234, 255);"><section style="padding-right: 5px;padding-left: 5px;outline: 0px;background-color: rgb(203, 234, 255);color: rgb(30, 30, 30);"><p style="outline: 0px;"><strong style="outline: 0px;">医保报销比例</strong></p></section></section></section></section><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="outline: 0px;">需要注意的是，医疗保险主张“保而不包”，对于产生的诊疗费用，会按照相应的比例进行报销。根据地区和要求的不同，医保的报销比例有所不同，您可以前往当地医保部门查询。<br style="outline: 0px;"></p><p style="outline: 0px;text-align: center;"><span class="wxart_image" wx-style="display:inline-block;outline: 0px;visibility: visible !important;width: 677px !important;"></span></p></section><section powered-by="xiumi.us" style="margin-top: 10px; margin-bottom: 10px; outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><section style="padding-right: 2px;outline: 0px;display: inline-block;vertical-align: middle;border-right: 2px solid rgb(203, 234, 255);border-top-color: rgb(203, 234, 255);border-bottom-color: rgb(203, 234, 255);border-left-color: rgb(203, 234, 255);"><section style="padding-right: 3px;outline: 0px;border-right: 3px solid rgb(203, 234, 255);border-top-color: rgb(203, 234, 255);border-bottom-color: rgb(203, 234, 255);border-left-color: rgb(203, 234, 255);"><section style="padding-right: 5px;padding-left: 5px;outline: 0px;background-color: rgb(203, 234, 255);color: rgb(30, 30, 30);"><p style="outline: 0px;"><strong style="outline: 0px;">医保报销公式</strong></p></section></section></section></section><section powered-by="xiumi.us" style="outline: 0px; font-family: system-ui, -apple-system, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; letter-spacing: 0.544px; font-size: 16px;"><p style="outline: 0px;">医保报销的费用=【(甲类药品的全部费用+乙类药品扣除自费部分的费用+其他符合医保规定的费用)-起付线】x报销比例<br style="outline: 0px;"></p><p style="outline: 0px;"><br style="outline: 0px;"></p><p style="outline: 0px;">了解了影响医保报销的几大因素后，如果您还不清楚报多少可以来试试这道“应用题”！</p><p style="outline: 0px;"><br style="outline: 0px;"></p><p style="outline: 0px;">示例：王大爷某次就医，发生了医保目录范围内的诊疗费用2000元，甲类药品1000元，乙类药品2000元。假设当地的乙类药品的自付比例为10%，起付线是800元，王大爷参加的某地城乡居民医保的报销比例为80%。请问，王大爷的医保可以报销多少钱？</p><p style="outline: 0px;"><br style="outline: 0px;"></p><p style="outline: 0px;">答：根据上面的公式，王大爷可以报销的费用=(“医药费的总和”-“乙类药品中需要自行支付的费用”-“起付线费用”)ד报销比例”。</p><p style="outline: 0px;"><br style="outline: 0px;"></p><p style="outline: 0px;">即(2000+1000+2000-2000×10%-800)×80%＝3200(元)</p></section><section powered-by="xiumi.us" data-mpa-powered-by="yiban.io" style="outline: 0px; letter-spacing: 0.544px; color: rgb(34, 34, 34); visibility: visible;"><section style="outline: 0px; visibility: visible;"><section style="outline: 0px; visibility: visible;"><section style="outline: 0px; visibility: visible;"><section style="margin-bottom: 24px; outline: 0px; visibility: visible;"><section powered-by="xiumi.us" style="outline: 0px; visibility: visible;"><section powered-by="xiumi.us" style="outline: 0px; visibility: visible;"><section label="Powered by 135editor.com" data-role="outer" data-darkmode-bgcolor-16379668336634="rgb(25, 25, 25)" data-darkmode-original-bgcolor-16379668336634="#fff|rgb(255, 255, 255)" data-darkmode-color-16379668336634="rgb(163, 163, 163)" data-darkmode-original-color-16379668336634="#fff|rgb(166, 166, 166)" data-style="white-space: normal; outline: 0px; max-width: 100%; background-color: rgb(255, 255, 255); font-size: 16px; caret-color: rgb(0, 0, 0); text-align: left; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; color: rgb(166, 166, 166); letter-spacing: 0.54px; box-sizing: border-box !important; overflow-wrap: break-word !important;" style="outline: 0px; color: rgb(166, 166, 166); caret-color: rgb(0, 0, 0); letter-spacing: 0.54px;"><section data-role="paragraph" data-darkmode-bgcolor-16379668336634="rgb(25, 25, 25)" data-darkmode-original-bgcolor-16379668336634="#fff|rgb(255, 255, 255)" data-darkmode-color-16379668336634="rgb(163, 163, 163)" data-darkmode-original-color-16379668336634="#fff|rgb(166, 166, 166)" style="outline: 0px;"><hr data-darkmode-bgcolor-16379668336634="rgb(25, 25, 25)" data-darkmode-original-bgcolor-16379668336634="#fff|rgb(255, 255, 255)" data-darkmode-color-16379668336634="rgb(163, 163, 163)" data-darkmode-original-color-16379668336634="#fff|rgb(166, 166, 166)" style="font-size: 16px; font-family: -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif; outline: 0px; line-height: 25.6px; letter-spacing: 0.54px;"><section data-darkmode-bgcolor-16379668336634="rgb(25, 25, 25)" data-darkmode-original-bgcolor-16379668336634="#fff|rgb(255, 255, 255)" data-darkmode-color-16379668336634="rgb(163, 163, 163)" data-darkmode-original-color-16379668336634="#fff|rgb(166, 166, 166)" style="text-align: center; outline: 0px; letter-spacing: 0.54px;"><font face="微软雅黑" style="" size="1"><span data-darkmode-bgcolor-16379668336634="rgb(25, 25, 25)" data-darkmode-original-bgcolor-16379668336634="#fff|rgb(255, 255, 255)" data-darkmode-color-16379668336634="rgb(163, 163, 163)" data-darkmode-original-color-16379668336634="#fff|rgb(166, 166, 166)|rgb(178, 178, 178)" data-style="outline: 0px; max-width: 100%; letter-spacing: 0.54px; color: rgb(178, 178, 178); font-size: 12px; box-sizing: border-box !important; overflow-wrap: break-word !important;" style="outline: 0px; color: rgb(178, 178, 178); letter-spacing: 0.54px;">来源<span style="outline: 0px; letter-spacing: 0.54px;"> ：</span></span><span data-darkmode-bgcolor-16379668336634="rgb(25, 25, 25)" data-darkmode-original-bgcolor-16379668336634="#fff|rgb(255, 255, 255)" data-darkmode-color-16379668336634="rgb(163, 163, 163)" data-darkmode-original-color-16379668336634="#fff|rgb(166, 166, 166)|rgb(178, 178, 178)" data-style="outline: 0px; max-width: 100%; letter-spacing: 0.54px; color: rgb(178, 178, 178); font-size: 12px; box-sizing: border-box !important; overflow-wrap: break-word !important;" style="outline: 0px; color: rgb(178, 178, 178); letter-spacing: 0.54px;">中国会计报、陕西医保</span></font></section><section data-darkmode-bgcolor-16379668336634="rgb(25, 25, 25)" data-darkmode-original-bgcolor-16379668336634="#fff|rgb(255, 255, 255)" data-darkmode-color-16379668336634="rgb(163, 163, 163)" data-darkmode-original-color-16379668336634="#fff|rgb(166, 166, 166)" style="text-align: center; outline: 0px; letter-spacing: 0.54px;"><img src="https://www.yewn.cn/data/attachment/forum/202312/19/085207s99glyclv3kfia4b.png"></section></section></section></section></section></section></section></section></section></section><p style="display: none;"><mp-style-type data-value="3"></mp-style-type></p></div> 谢谢发布，已转发 影响报销的四大因素 感谢你的分享 谢谢分享一下 涨知识啦！！ 掌握医保政策，报销不吃亏…… 快进来学习一下。 感谢你的分享 让老百姓吃放心药低价药
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