How much can general hospitalization social security be reimbursed?

Medical reimbursement is only divided into rural residents and urban workers, regardless of whether they are poor or not.

1, residents' reimbursement ratio: town health centers reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.

2, urban residents, in a settlement year, the medical expenses that meet the scope of reimbursement are 65,438+10,000 yuan, the threshold for tertiary hospitals is 659 yuan, the reimbursement ratio is 50%, and the upper limit is 2,000 yuan; The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.

The reimbursement process of medical insurance card is as follows:

1, medical insurance hospitalization, show the medical insurance card, read the card and enter the medical insurance system, and pay the deposit (usually the threshold fee);

2. The expenses incurred are entered into the system, and the system automatically classifies them as self-funded, Class A and Class B, etc. Class B pays 10% first, and then enters the basic medical care. According to the number of hospitalizations per year (more than 1 time, the threshold fee is halved) and the hospital level (the threshold fee is different, and the overall proportion is different);

3. Calculate how much you should pay and how much the hospital will settle with the social security medical insurance center.

Legal basis:

"Regulations on the Implementation of the Social Insurance Law" Article 8 If the medical expenses incurred by the insured in the agreed medical institutions meet the standards of the basic medical insurance drug list, diagnosis and treatment items and medical service facilities, they shall be paid by the basic medical insurance fund in accordance with state regulations.

If the insured really needs emergency treatment and rescue, he can seek medical treatment in a non-agreement medical institution; The scope of drugs that must be used for rescue can be appropriately relaxed. The specific measures for the administration of emergency and rescue medical services of the insured shall be formulated by the overall planning area according to the local actual situation.