What is the reimbursement rate of medical insurance in 2022

Hello dear, 1Medical insurance is mainly divided into employee medical insurance and resident medical insurance, and the reimbursement ratio is also different; 2.The reimbursement ratio of employee medical insurance is divided according to the level of hospitalization expenses, with the reimbursement ratio between 1,300 yuan and 30,000 yuan being 85%, the reimbursement ratio between 30,000 yuan and 40,000 yuan being 90%, the reimbursement ratio being 95% between 40,000 yuan and 100,000 yuan, and the reimbursement ratio being between 100,000 yuan and 300,000 yuan being 85%; 3.

Residents' medical insurance is composed of the merger of urban residents' medical insurance and NCMS. The reimbursement ratio is 65% for first-class hospitals, and the minimum payment line is 300 yuan; The reimbursement ratio of secondary hospitals below 6,000 yuan is 65%, and the reimbursement ratio of more than 6,000 yuan is 80%, of which the starting line of county secondary hospitals is 400 yuan, and the starting line of municipal secondary hospitals is 600 yuan.

The new policy on the reimbursement ratio of medical insurance in 2022 is as follows:

1. Medical insurance is mainly divided into employee medical insurance and resident medical insurance, and the reimbursement ratio is also different;

2. The reimbursement ratio of employee medical insurance is divided according to the level of hospitalization expenses, the reimbursement ratio between 1,300 yuan and 30,000 yuan is 85, the reimbursement ratio between 30,000 yuan and 40,000 yuan is 90, the reimbursement ratio between 40,000 yuan and 100,000 yuan is 95, and the reimbursement ratio between 100,000 yuan and 300,000 yuan is 85;

3. Residents' medical insurance is composed of the merger of urban residents' medical insurance and NCMS. The reimbursement ratio is 65% for first-class hospitals, and the minimum payment line is 300 yuan; The reimbursement ratio of secondary hospitals below 6,000 yuan is 65%, and the reimbursement ratio of more than 6,000 yuan is 80%, of which the starting line of county secondary hospitals is 400 yuan, and the starting line of municipal secondary hospitals is 600 yuan.

Social Insurance Law of the People's Republic of China

Article 23.

Employees shall participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state.

Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

The reimbursement ratio of employee medical insurance in 2022 is determined on a case-by-case basis.

Outpatient reimbursement ratio: After the basic medical insurance for urban employees, if it is an in-service employee, after going to the outpatient and emergency department of the hospital, the medical expenses of more than 2,000 yuan can be reimbursed, and the reimbursement ratio is 50%. If it is a retiree under the age of 70, the expenses above 1,300 yuan can be reimbursed, and the reimbursement ratio is 70%.

Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by the risk of disease. Through the employer and individual payment, the establishment of medical insurance**, after the insured person is sick and incurs medical expenses, the medical insurance institution will give him a certain amount of economic compensation.

The establishment and implementation of the basic medical insurance system gathers the economic strength of the unit and the members of the society, coupled with the first funding, which can enable the sick members of the society to obtain the necessary material help from the society, reduce the burden of medical expenses, and prevent the sick members of the society from "becoming poor due to illness".

Medical insurance has the basic characteristics of social insurance, such as compulsory, mutual aid and sociality. The medical insurance system is usually enforced by national legislation, and the first system is established, the cost is jointly paid by the employer and the individual, and the medical insurance premium is paid by the medical insurance institution to solve the medical risk caused by the illness or injury of the worker.

Medical insurance, like other types of insurance, is a contract to collect medical insurance premiums in advance from people who are threatened by disease, and establish medical insurance**; When the insured falls ill and goes to a medical institution for medical treatment and incurs medical expenses, the medical insurance institution will give certain financial compensation. Therefore, medical insurance also has two major functions of insurance: risk transfer and compensation transfer.

That is, the economic loss caused by the risk of disease in the individual is apportioned to all members who are threatened by the same risk, and the economic loss caused by the disease is compensated by the centralized medical insurance**.

Commercial medical insurance can be divided into reimbursement medical insurance and compensation medical insurance.

Reimbursement-based medical insurance means that the medical expenses incurred by patients in the hospital are reimbursed by the insurance company, which is generally divided into outpatient medical insurance and inpatient medical insurance.

Indemnity medical insurance means that the patient is clearly diagnosed by the hospital with a certain disease listed in the contract, and the insurance company pays the patient** and care according to the amount agreed in the contract. Generally, there are two types of insurance: single illness insurance and critical illness insurance.

[Legal basis].

Social Insurance Law of the People's Republic of China

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 administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits.