Zhuhai medical insurance reimbursement ratio 2022

Zhuhai Medical Insurance Reimbursement Ratio 2022 is as follows:

1. Medical expenses incurred in outpatient clinics shall be reimbursed in accordance with the following ratios, and the remaining part shall be paid by the individual:

(1) 35 percent of medical expenses less than 1,000 yuan;

(2) 45 percent of medical expenses less than 5,000 yuan, 45 percent reimbursement;

(3) medical expenses above 5,000 yuan (including 5,000 yuan) and less than 10,000 yuan, 55 percent reimbursement;

(4) medical expenses above 10,000 yuan (including 10,000 yuan), 65 percent reimbursement.

2. Medical expenses incurred in the hospitalized Medical expenses that meet the requirements will be reimbursed at the following rates, with the remainder to be paid by the individual, and the medical expenses for multiple hospitalizations within the year will be calculated cumulatively:

(1) For the portion of the medical expenses of less than 10,000 yuan, the reimbursement rates for the medical treatment at the third-level, second-level and first-level medical institutions shall be 55, 65 and 75 percent, respectively;

(2) The reimbursement rate for the portion of the medical expenses of 10,000 yuan (including 10,000 yuan) or more, but less than 20,000 yuan, in third-level, second-level and first-level medical institutions, the reimbursement rate is 60 percent, 70 percent and 80 percent, respectively;

(3) medical expenses of 20,000 yuan (including 20,000 yuan) or more in third-level, second-level and first-level medical institutions, the reimbursement rate is 65 percent, 75 percent, respectively.

Legal basis: Article 23 of the Social Insurance Law of the People's Republic of China

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

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in their employing units, and other flexibly employed persons may participate in the basic medical insurance for employees, and individuals shall pay the basic medical insurance premiums in accordance with the state regulations.