Reimbursement ratio of rural urban medical insurance

The reimbursement rate of rural medical insurance is 85%. If it exceeds the basic limit, the social security department will reimburse 85% for the amount below RMB 0-40,000, 90% for the amount below RMB 40,000-80,000, and 95% for the amount above RMB 80,000. The insured residents' hospitalization medical expenses within the policy scope of the designated medical institutions of basic medical insurance in the overall planning area, and the part above the minimum threshold shall be paid by the urban and rural residents' medical insurance fund in proportion: the township hospitals and community health service institutions shall not be less than 80%; County-level medical institutions are not less than 70%; Municipal medical institutions are not less than 60%. Each overall planning area reasonably determines the specific payment ratio according to the income and expenditure of urban and rural residents' medical insurance fund. Medical insurance is one of the basic social security policies in China, which provides basic protection for the health of China residents.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Derivative problem:

What is the proportion of reimbursement for medical treatment in different places without filing?

The reimbursement rate for medical treatment in different places is 70%, and the reimbursement rate for hospitalization of insured persons in different places is 70%; The reimbursement rates of employees in different places are 82%, 86% and 90% respectively, and the reimbursement rates of retirees in different places are 965, 438+0%, 93% and 95% respectively. The proportion of reimbursement for transfer to hospital is 77% for employees and 89% for retirees; Non-emergency hospitalization will not be transferred, and medical expenses within the policy scope will be reimbursed by 50%.