Social security accident insurance reimbursement ratio

Medical insurance reimbursement does not distinguish between diseases and accidents, and all medical expenses are reimbursed according to the same standard, but the expenses that should be paid from industrial injury insurance or borne by a third party are not reported by medical insurance. If it is determined that it is an industrial accident or an accident caused by a third party, medical insurance will not be reimbursed.

The proportion and scope of medical insurance reimbursement are related to local medical insurance policies.

For example, the proportion of medical insurance reimbursement for employees in Guangzhou is: hospitalization reimbursement, 400 yuan, the deductible line of first-class hospitals, and the reimbursement ratio is 90%; The deductible line of secondary hospitals is 800 yuan, and the reimbursement rate is 85%; The deductible line of tertiary hospital 1600 yuan, with the reimbursement rate of 80%.

The reimbursement rate of medical insurance for urban and rural residents in Guangzhou is: hospitalization reimbursement, first-class hospital deductible line 150 yuan, and the reimbursement rate is 90%; 300 yuan, the deductible line of secondary hospitals, the reimbursement rate is 80% (85% for minors and students); The deductible line of tertiary hospitals is 500 yuan, and the reimbursement rate is 70% (80% for minors and students).

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