What is the maximum amount of social security reimbursement for serious illness?

The maximum reimbursement amount for major social security diseases refers to the maximum reimbursement amount when the reimbursement ratio of medical expenses incurred by insured persons due to major diseases is gradually increased to the maximum reimbursement ratio after deducting the deductible. The specific amount standard depends on factors such as different regions and hospitals.

The maximum reimbursement amount for major social security diseases refers to the maximum reimbursement amount when the reimbursement ratio of medical expenses incurred by insured persons due to major diseases is gradually increased to the maximum reimbursement ratio after deducting the deductible. The system aims to ensure that the insured can get a certain degree of financial support when they are hit by high medical expenses. According to the relevant national policies and regulations, the maximum reimbursement amount for major diseases is set by the local government or medical insurance department according to the actual situation and the allocation of medical resources. The specific amount varies with the region, hospital type, disease type and other factors. For example, in Beijing, 202 1, the maximum reimbursement for major diseases of employees participating in medical insurance is 70,000 yuan; In Foshan City, Guangdong Province, the maximum reimbursement amount for major diseases of employees participating in medical insurance is 6.5438+0.5 million yuan on 202 1. It should be noted that the maximum reimbursement amount for serious illness is only the maximum reimbursement amount, and the specific reimbursement ratio and actual reimbursement amount are also affected by other factors, such as hospital level, medical expenses, and cumulative use of personal accounts.

What should I do if I exceed the reimbursement limit for major diseases? If the patient's medical expenses exceed the upper limit of reimbursement for major diseases, he can still continue to be reimbursed, but the reimbursement ratio will be discounted. The proportion of reimbursement after discount is determined by the local government or medical insurance department, which is generally between 50% and 80%. If the balance of personal account is not enough to pay the excess, you still need to pay by yourself.

The maximum reimbursement amount for major social security diseases is an important system to protect the rights and interests of insured persons. The specific amount varies with the region, hospital type, disease type and other factors. If the patient's medical expenses exceed the upper limit of reimbursement for major diseases, he can still continue to be reimbursed, but the reimbursement ratio will be discounted. Insured personnel should pay attention to social security expenses in time to ensure that they can enjoy the corresponding social security benefits.

Legal basis:

Article 12 of the Social Insurance Law of People's Republic of China (PRC) * * * The employing unit shall pay the basic old-age insurance premium according to the proportion of the total wages of employees stipulated by the state and record it in the basic old-age insurance pooling fund. Employees shall pay the basic old-age insurance premium in accordance with the proportion of wages stipulated by the state and record it in their personal accounts.