What is the reimbursement ratio of medical insurance for serious illness?

Legal analysis: First, the proportion of reimbursement for serious illness medical insurance:

1, and 55% of the accumulated amount is more than 1.2 million yuan and less than 30,000 yuan (inclusive);

2, 30,000 yuan more than 6,543,800 yuan+10,000 yuan (inclusive) the following part pays 65%;

3 more than 65.438 billion yuan to pay 75%, the annual maximum payment limit is not less than 300 thousand yuan in principle.

Note: When calculating the cumulative personal burden of serious illness insurance, the amount of medical assistance enjoyed by poor patients in that year is not deducted. We will provide effective protection and accurate assistance to patients with excessive personal burden after reimbursement of basic medical insurance and compensation for serious illness insurance, precise poverty alleviation targets, and poor people who have no money to abandon medical treatment.

Second, the scope of reimbursement of serious illness medical insurance, the personal burden of the insured in the reimbursement of basic medical insurance for serious illness medical insurance, and the reimbursement of supplementary medical insurance for serious illness is 75%.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.

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

Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.