Proportion of social security reimbursement for medical expenses in 3A hospitals

Legal analysis: The higher the hospital level, the more reimbursement sections and the lower the reimbursement ratio. The reimbursement ratio of 3A hospitals is as follows:

(1) 80% of the deductible line from 800 yuan to 5,000 yuan;

(2) 85% will be reimbursed from 5000 yuan to 10000 yuan;

(3) 90% of the part above the maximum payment limit 10000 yuan;

(4) Retirees will be increased by 5% on the basis of the above reimbursement ratio.

Legal basis: Regulations of People's Republic of China (PRC) Municipality on Basic Medical Insurance for Urban Workers.

Twenty-eighth personal accounts are used to pay medical expenses beyond the scope of the overall fund; If the personal account is insufficient to pay, it shall be borne by me.

Twenty-ninth serious illness hospitalization medical expenses, according to the following methods to pay:

(a) Qifubiaozhun in principle control in the city, county, autonomous county last year, the average social wage of workers 9%-0%.

(two) the maximum payment limit is controlled in principle at 3-5 times of the average social wage of employees in cities, counties and autonomous counties in the previous year.

(three) medical expenses above the minimum deductible and below the maximum payment limit are mainly paid by the overall fund, and individuals bear a certain proportion. Give appropriate care to the proportion of retirees who bear medical expenses.

The scope of serious diseases, the specific standards of Qifubiaozhun and the maximum payment limit, and the proportion of sharing medical expenses above Qifubiaozhun and below the maximum payment limit shall be determined by the provincial people's government.

Thirtieth medical expenses below Qifubiaozhun and above the maximum payment limit shall not be paid by the overall fund. Thirty-first basic medical insurance fund to pay part of the cost of diagnosis and treatment projects and class B drugs list, the proportion of individual pays, determined by the provincial people's government.