What percentage can be reimbursed for medical insurance hospitalization?

Legal analysis: first, the use of special medical materials or disposable medical materials with a unit price of more than 1000 yuan, as well as the installation and replacement of artificial organs, shall be paid by the basic medical insurance pooling fund according to the domestic general price; Second, the basic medical expenses for outpatient dialysis of chronic renal failure, outpatient anti-rejection drugs after organ transplantation, outpatient chemotherapy, radiotherapy, interventional therapy or radionuclide therapy are paid by the basic medical insurance pooling fund; Third, the outpatient special examination and treatment costs are paid by the basic medical insurance fund 80%, and the individual pays 20%; Fourth, continuous payment is linked to the reimbursement ratio. After two years of continuous insurance, the reimbursement rate increased to 765,438+0%, and after four years of continuous insurance, the reimbursement rate increased to 72%, and so on. It should be reminded that the reimbursement ratio of social security cards in different cities is different, which is mainly related to the local medical insurance benefits. It is suggested that you can call the social security number 12333 for consultation, or consult the local social security bureau! Matters needing attention for hospitalization reimbursement of social security card: 1. The reimbursement ratio of different hospitals and different medical insurance is different. A person spends 10000 yuan in a hospital. If he is hospitalized in a first-class hospital, 500 yuan will be deducted first; If you are hospitalized in a secondary hospital, first subtract 1000 yuan; If you are hospitalized in a tertiary hospital, you will be reduced by 2000 yuan first; After excluding "non-medical insurance drug expenses" and "other non-medical insurance expenses", the remaining employees reported 80%, retired or unemployed, and unemployed 50%. Note: Medical insurance reimbursement only covers Class A drugs, that is, medical insurance drugs, and Class B drugs are not medical insurance and cannot be reimbursed. 2. On-the-job employee hospitalization medical insurance reimbursement ratio hospitalization, except for the self-funded part and self-paid 10%, the part exceeding the deductible of hospitalization medical insurance enjoys the overall payment ratio. Different levels of hospitals have different threshold fees and enjoy different proportions of overall payment. The proportion of medical insurance for employees is over 80% (82%/84%/87% in Wuhan), and that for residents is about 70% (80%/65%/50% in Wuhan).

Legal basis: Article 28 of the full text of People's Republic of China (PRC) Social Insurance Law conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and 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. Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope: (1) should be paid by the industrial injury insurance fund; (2) It shall be borne by a third party; (three) shall be 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. Thirty-first social insurance agencies may, according to the needs of management services, sign service agreements with medical institutions and pharmaceutical business units to standardize medical service behavior. Medical institutions shall provide reasonable and necessary medical services for the insured.

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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.