What is the reimbursement limit? What is the limit reimbursement of medical insurance?

There is an upper limit.

Whether it is employee medical insurance or domestic medical insurance, there is a minimum payment line and a cap line, but due to different regions, the reimbursement limit is also different, and the country is not uniform. Generally speaking, the reimbursement limit is closely related to the economic level of the city, and the reimbursement limit in some areas is 150,000, and the reimbursement limit in some areas is only 300,000. Therefore, it depends on the economic level of the region.

Hello, the reimbursement amount of special outpatient clinics for chronic diseases is limited every year, and the reimbursement amount for diseases is different.

Chronic diseases are fixed fees, which are the same every year, for example, the annual reimbursement ratio for diabetics is 1200 yuan, and after your reimbursement reaches 1200, the rest can only take medicine at your own expense, and the others are the same.

There are also many grades of medical insurance, and then some of the medicines you take are covered by medical insurance.

There is an upper limit on the reimbursement amount of social security medical insurance.

The maximum payment limit is commonly referred to as the "ceiling line", which is the maximum amount of medical expenses paid to employees and retirees in an insurance year, and the medical expenses that exceed the maximum payment limit do not belong to the scope of overall payment.

1) The maximum reimbursement amount of medical insurance for urban residents:

Outpatient reimbursement: 2,000 yuan.

Hospitalization reimbursement: 170,000 yuan.

2) The maximum reimbursement amount of medical insurance for urban employees:

Outpatient reimbursement: 20,000 yuan.

Hospitalization reimbursement: 300,000 yuan.

Fifty percent in the city and 50 percent in the province.

The indicators of local hospitals are different, you can go to the relevant departments for consultation.

Is there a medical insurance reimbursement ceiling?

There is an upper limit on the reimbursement amount of social security medical insurance.

Hand dismantling 1, the maximum payment limit is commonly referred to as the "ceiling line", which is the maximum amount of medical expenses paid to employees and retirees in an insurance year, and the medical expenses that exceed the maximum payment limit do not belong to the overall payment.

Range. 2. Social security medical reimbursement is proportional, up to 90%, and then set back to the upper limit, which is related to the cumulative payment time of medical insurance, the longer the cumulative payment time, the higher the upper limit, and there is also a certain starting line - that is, deductible.

Is there a medical insurance reimbursement ceiling and what is the upper limit?

What is the maximum reimbursement limit for Medicare.

Medical insurance for urban residents.

Maximum reimbursement amount.

Outpatient reimbursement: 2,000 yuan.

Hospitalization reimbursement: 170,000 yuan.

The maximum reimbursement amount of medical insurance for urban employees.

Outpatient reimbursement: 20,000 yuan.

Hospitalization reimbursement: 300,000 yuan.

Supplementary notes: 1. The maximum reimbursement amount refers to the cumulative payment in a medical insurance year.

2. The maximum upper limit of hospitalization reimbursement for Sunqiao urban employee medical insurance is 300,000 yuan, which is the maximum payment limit of 100,000 yuan for basic medical insurance and 200,000 yuan for large mutual aid funds.

Legal analysis: 1) The maximum reimbursement amount of medical insurance for urban residents:

Outpatient reimbursement: 2,000 yuan.

Hospitalization reimbursement: 170,000 yuan.

2) The maximum reimbursement amount of medical insurance for urban employees:

Outpatient reimbursement: 20,000 yuan.

Hospitalization reimbursement fee: 300,000 yuan.

Legal basis: Social Insurance Law of the People's Republic of China Article 30 The following medical expenses are not included in the scope of payment of basic medical insurance**

1) It should be paid from work-related injury insurance**, (2) It should be borne by a third party, (3) It should be borne by public health, and (4) It should be paid for by a doctor outside the country.

Medical expenses shall be borne by the third party in accordance with the law, and if the third party does not pay or the third party cannot be determined, the basic medical insurance shall pay in advance. After the basic medical insurance** is paid in advance, it has the right to recover from the third party of the sedan leak.

Legal analysis: There is an upper limit on the reimbursement amount of medical insurance.

Legal basis: Notice of the Ministry of Finance and the State Administration of Taxation on Doing a Good Job in Basic Medical Security for Urban and Rural Residents in 2021

In order to support the consolidation and improvement of the level of residents' medical insurance benefits and gradually expand the scope of medical insurance payment, we will continue to raise the financing standards of residents' medical insurance in 2021. The per capita financial subsidy standard for residents' medical insurance has been increased by 30 yuan to no less than 580 yuan per person per year. At the same time, the individual payment standard for residents' medical insurance will be increased by 40 yuan to 320 yuan per person per year.

**The Ministry of Finance implements subsidies for local governments in accordance with regulations, and subsidizes the western and central regions according to the proportion of %, and subsidizes the provinces in the eastern region according to a certain proportion. Local finance departments at all levels should arrange financial subsidy funds in accordance with the regulations and allocate them in a timely manner. The household registration restrictions on participating in basic medical insurance will be further relaxed, and for those who hold residence permits to participate in local residents' medical insurance, financial departments at all levels should subsidize them according to the same standards as local residents.