Maximum reimbursement for hospitalization in Beijing medical insurance

Legal analysis: the upper limit of reimbursement is the highest limit borne by medical insurance. The maximum reimbursement limit for outpatient service in Beijing is 20,000 yuan, and the basic reimbursement value for hospitalization is 6,543,800 yuan. Plus a large subsidy of 200,000 yuan for hospitalization, the maximum reimbursement limit can reach 300,000 yuan. In other words, Beijing's medical insurance can help bear the treatment cost of up to 300,000 yuan.

1, medical insurance for urban workers

Upper limit of annual reimbursement for hospitalization in Beijing medical insurance: 300,000 yuan.

Deductible line: No matter whether employees or retirees are hospitalized for the first time1.From 300 yuan, the reimbursement rate is 85%. Second hospitalization, since 650 yuan, reimbursement rate: 85%.

2. Medical insurance for urban and rural residents

Upper limit of hospitalization reimbursement: 200,000 yuan.

Medical insurance conditions:

First, residents' medical insurance conditions

1. The applicant did not participate in social security registration in Beijing;

2. The applicant has a household registration in Beijing.

Second, the unit insurance conditions

Employee insurance conditions:

1, the enterprise has been registered in Beijing;

2. The employee has established labor relations with the enterprise and has not participated in social security registration in Beijing;

Legal basis: Article 29 of the Social Insurance Law of People's Republic of China (PRC) stipulates that the part of the medical expenses of the insured who should be paid by the basic medical insurance fund shall be directly settled by social insurance agencies, medical institutions and pharmaceutical trading 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.