How to reimburse social security and rural medical insurance?

Social security includes medical insurance, and the reimbursement method of medical insurance medical expenses is: (1) outpatient medical expenses reimbursement: outpatient family account is reimbursed according to the family limit, and the total amount is calculated according to each person 10 yuan and the number of indoor participants, and the whole family can adjust the use within the total reimbursement limit; Outpatient co-ordination is implemented according to the standard of 40 yuan/person/year, and the compensation ratio is 30% each time. Outpatient care should be people-oriented and family personnel adjustment should not be implemented. Out-of-county outpatient expenses will not be reimbursed temporarily. (2) Reimbursement of hospitalization medical expenses: reimbursement shall be managed with deductible line, reimbursement according to specified proportion and accumulative reimbursement capping. After the self-funded project is cleared, the medical expenses below the deductible standard shall be paid by the patient; For medical expenses exceeding the deductible line, the reimbursement rate is 75% in 50 yuan of the first-level hospital, 45% in 300 yuan of the second-level hospital, and 20% in the third-level hospital. Chinese medicine services will be increased by 10 percentage point on the basis of the compensation ratio of similar designated medical institutions. The maximum amount of accumulated reimbursement per person for the whole year is 30,000 yuan. (3) reimbursement of medical expenses for chronic disease clinics: According to your father's situation, you can be identified as a chronic disease patient. Within one year, the outpatient medical expenses of the month of hospitalization due to illness will be deducted, and the remaining expenses will exceed 150 yuan. On the basis of the chronic disease diagnosis certificate, outpatient invoice, prescription, hospital outpatient medical records, household registration book and diagnosis certificate that I applied for and designated the hospital. Submit it to township hospitals or central hospitals for review before June 30th of that year 165438+, and submit it to the county joint management office for approval before June 65438+February 10, and make compensation in the chronic disease medical fund. The deductible line is 150 yuan, and the compensation ratio is determined by the county joint management office according to the incidence of chronic diseases in the county.

Legal objectivity:

"People's Republic of China (PRC) Social Insurance Law" Article 23 * * * employees shall participate in the basic medical insurance for employees, and employers and employees shall pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.