Social security reimbursement how to calculate

Social basic medical insurance reimbursement how to calculate, to see the small organization. First, the specific amount of reimbursement almost everyone knows on the medical insurance, does not mean that all the medical expenses can be reimbursed, but for the specific amount of reimbursement, can be clear and not much. After the medical insurance, if you are a working employee, to the hospital outpatient, emergency room, 2000 yuan want to know more about the basic social health insurance reimbursement how to calculate the knowledge, follow along to see it.

A specific amount of reimbursement

Almost everyone knows that on the health insurance, does not mean that all the medical expenses can be reimbursed, but for the specific amount of reimbursement, can be clear and not much.

After the health insurance, if you are an active employee, to the hospital outpatient, emergency treatment, more than 2,000 yuan of medical expenses can be reimbursed, the reimbursement rate is 50%. For retirees under the age of 70, the reimbursement rate is 70% for expenses over 1,300 RMB. For retirees over the age of 70, the reimbursement rate is 80% for expenses over $1,300. The maximum amount of outpatient and emergency medical expenses paid is 20,000 yuan for all categories of people. For example, if you are an active employee and spend 2,500 yuan on an outpatient visit, you will be reimbursed 50 percent of the 500 yuan, or 250 yuan.

The basic medical insurance fund

In the case of hospitalization, the first time you use the basic medical insurance to pay for the first time in a year, whether you are an employee or a retiree, the starting amount is 1,300 yuan. For the second and subsequent hospitalizations, the threshold is set at 50 percent, or 650 yuan. The maximum amount payable by the basic medical insurance fund (for hospitalization expenses) in a year is currently 70,000 yuan. The standard of hospitalization reimbursement is related to the level of the hospital in which the insured person is staying, for example, if the hospital is a tertiary hospital, from the starting standard to 30,000 yuan, the employee pays 15%, that is, 85% reimbursement; from 30,000 yuan to 40,000 yuan, the employee pays 10%, reimbursement of 90%; more than 40,000 yuan to the maximum payment limit of the part of the cost of the reimbursement of 95% of the part of the cost of the reimbursement, the employee only needs to pay 5%. The proportion of individual payments for retirees is 60% of that for active (that is, the aforementioned) employees, but below the threshold, all paid by the individual.

Tips: hospitalization reimbursement standard and the insured person lives in the hospital level related, such as living in a tertiary hospital, from the starting standard to 30,000 yuan of the cost, the employee pays 15%, that is, reimbursement of 85%; 30,000 yuan to 40,000 yuan of the cost, the employee pays 10%, reimbursement of 90%.

The above is for you to introduce the basic social health insurance reimbursement how to calculate the knowledge, I hope to help you, if there are still questions, you can contact a lawyer for you to answer.