Social Security Card Hospitalization Reimbursement Percentage

The amount and percentage of hospitalization reimbursement by Social Security card is subject to certain legal requirements. The starting rate for the first hospitalization in a natural year is 1,300 yuan, and is reduced to 650 yuan for each subsequent hospitalization. Specific payment rates are divided into three brackets, using tertiary hospitals as an example:

Within the $30,000 range of medical expenses, active employees are reimbursed 85 percent, while retirees are eligible for 91 percent reimbursement. If medical expenses are between $30,000 and $40,000, reimbursement rises to 90 percent for active employees and 94 percent for retirees. When medical expenses exceed $40,000, the reimbursement rate is 95 percent for active employees and further increased to 97 percent for retirees.

These provisions stem from the Social Insurance Law of the People's Republic of China. The law aims to regulate social security relations, safeguard citizens' rights to material help from the state and society in old age, illness and other situations, and achieve social harmony and stability. The law stipulates that the State has established a multi-level social insurance system, including basic pension insurance and medical insurance, to ensure broad coverage and a basic level of protection, and that the level of reimbursement is commensurate with the level of economic and social development. Both active employees and retirees have the right to inquire about contribution records, monitor unit contributions, and receive social insurance counseling and other related services.