What is the reimbursement ratio for hospitalization expenses and what is the reimbursement ratio for

What is the reimbursement ratio for hospitalization under employee medical insurance?

Medical insurance is divided into employee medical insurance and urban and rural residents' medical insurance, and the reimbursement ratio varies from place to place. Take Beijing employee medical insurance as an example: the maximum limit is 20,000 yuan.

In-service employees can be reimbursed for outpatient and emergency medical expenses of more than 1,800, with a reimbursement ratio of 50%; Retirees can be reimbursed for outpatient and emergency medical expenses of more than 1,300 yuan, 70% for those under 70 years old, and 80% for those over 70 years old.

Consult social security questions, check account amounts, medical insurance reimbursement details, pension calculations, and welcome to Chayue Social Security.

Medical insurance is mainly divided into employee medical insurance and urban and rural residents' medical insurance, and the reimbursement ratio varies from place to place. Employee health insurance: Reimbursement rates vary for active employees, retirees under the age of 70, and retirees over the age of 70.

As for the medical insurance for urban and rural residents, the starting line and reimbursement ratio are different in different places. You can log on to the official website of the local human resources and social security bureau for inquiries.

Summary. The reimbursement ratio of medical insurance is as follows: the hospitalization reimbursement ratio of employee medical insurance is 85% for hospitalization expenses between 1,300 yuan and 30,000 yuan; The reimbursement ratio is 90% between 30,000 yuan and 40,000 yuan, 95% between 40,000 yuan and 100,000 yuan, and 85% between 100,000 yuan and 300,000 yuan.

The reimbursement ratio of resident medical insurance is 65% for first-level hospitals and 80% for second-level hospitals with more than 6,000 yuan.

The reimbursement ratio of medical insurance is as follows: the hospitalization reimbursement ratio of employee medical insurance, the hospitalization fee between 1,300 yuan and 30,000 yuan is 85%; The reimbursement ratio for the third brother is 90% between 10,000 yuan and 40,000 yuan, 95% for 40,000 yuan and 100,000 yuan, and 85% for 100,000 yuan and 300,000 yuan. The reimbursement ratio of resident medical insurance is 65% for first-level hospitals and 80% for second-level hospitals with more than 6,000 yuan.

Legal basis: Article 28 of Zhengqing's "Social Insurance Law" complies with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, and medical expenses for emergency and rescue, and shall be paid from the basic medical insurance in accordance with national regulations. Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance shall be directly settled by the social insurance agency and the medical institution and the drug business unit.

The social insurance administrative department and the health administrative department shall establish a system for settling medical expenses for medical treatment in other places, so as to facilitate the insured persons to enjoy the basic medical insurance benefits.