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居民50元职工150元,河南新乡门诊医保报销每日限额,官方回应
Di Yi Cai Jing· 2025-11-10 10:11
Group 1 - The core issue is the implementation of daily reimbursement limits for medical insurance in Xinxiang, with residents capped at 50 yuan and employees at 150 yuan, effective from June 13, 2025 [2][4] - The Xinxiang Medical Insurance Bureau stated that without these limits, the insurance fund could face a deficit by the end of the year, emphasizing the need for efficient fund management [4][6] - The adjustment aims to prevent fraud in the medical insurance system and to standardize medical practices in hospitals and clinics, with the bureau asserting that typical outpatient expenses are around 100 to 200 yuan per visit [7] Group 2 - The bureau clarified that the new limits are not indicative of a funding shortfall but are a preventive measure against fraudulent claims [6][7] - Patients needing to exceed the daily limit are encouraged to self-pay the excess amount, as splitting large expenses over multiple days is not compliant with insurance regulations [7]