Proportion of reimbursement for first-class medical insurance in Shenzhen

Legal analysis: the reimbursement rate of primary outpatient service of basic medical insurance is about 93%, the reimbursement rate of secondary medical insurance is about 8 1%, and the reimbursement rate of tertiary medical insurance is about 73%, totaling about 89%; The reimbursement rate of the first file of basic medical insurance is about 93%, the second file is about 88%, and the third file is about 78%, making a total of about 90%. Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the contributions of employers and individuals. After the insured person has medical expenses, the medical insurance institution will give certain economic compensation. The establishment and implementation of the basic medical insurance system has gathered the economic strength of units and social members. With the government's funding, sick social members can get the necessary material help from society, reduce the burden of medical expenses, and prevent sick social members from becoming poor due to illness.

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.

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