Proportion of residents' medical insurance reimbursement

1. Level-I hospital: reimbursement rate is 65%, with the deductible line being 300 yuan.

2. Secondary hospitals: for medical treatment in county secondary hospitals, the reimbursement rate of medical expenses below 6,000 is 65%, and the reimbursement rate of medical expenses above 6,000 is 80%; Pay line 400 yuan; In the secondary hospitals in the city, the reimbursement ratio is the same, and the deductible line is 600 yuan.

3. Third-level hospitals: for medical treatment in county-level third-level hospitals, the reimbursement rate of medical expenses above 600 is 65%, and the reimbursement rate of medical expenses above 6000 yuan is 80%. The deductible line is 600 yuan; In municipal tertiary hospitals, the reimbursement rate of medical expenses below 12000 is 55%, and above 12000 is 75%. Deductible, 800 yuan.

4. Hospitals outside the city: the reimbursement rate of medical expenses below 20,000 yuan is 45%, the reimbursement rate of medical expenses above 20,000 yuan is 70%, and the reimbursement deductible line is 1500 yuan.

The reimbursement limit for rural cooperative medical clinics is 5000 yuan per year.

Residents over the age of 60 are reimbursed for hospitalization expenses and nursing expenses 10 yuan every day, with the highest accumulated amount in 200 yuan.

The expenses of surgery are reimbursed according to the standard if they are within the deductible line 1000 yuan, and those exceeding 1000 yuan are reimbursed according to 1000 yuan, with the reimbursement limit of 1000 yuan.

Legal basis: Article 30 of the Social Insurance Law, the following medical expenses are not included in the payment scope of the basic medical insurance fund:

(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.

skill

The above answer is only for the current information combined with my understanding of the law, please refer carefully!

If you still have questions about this issue, I suggest you sort out relevant information and communicate with professionals in detail.