Social security workers hospitalization reimbursement rate

I. Employee social security hospitalization reimbursement ratio 1. First-class hospitals, the portion above the starting standard up to the maximum payment limit will be paid at 90%; 2. Second-class hospitals, the portion from the starting standard up to and including 10,000 yuan will be paid at 85%, and the portion above 10,000 yuan up to the maximum payment limit will be paid at 90%; 3. Third-class hospitals, the portion from the starting standard up to and including 5,000 yuan (inclusive) will be paid at 80%, the portion from 5,000 yuan to 10,000 yuan will be paid at 85%, and the portion above 10,000 yuan up to the maximum payment limit will be paid at 90%; 4. Retirees will be given a 5% increase on top of the above payment rates. Second, the scope of reimbursement for hospitalization of employees' health insurance 1. Expenses incurred during the period when the newly enrolled social security card is not issued; 2. Expenses incurred during the period when the social security card is lost and replaced; 3. Expenses incurred during the period of emergency treatment in designated medical institutions without the card; 4. Expenses incurred during the period of arrears of payment; 5. Expenses incurred during the period of manual reimbursement; 6. Expenses incurred while seeking medical treatment in a foreign port that meet the conditions of payment of the medical insurance fund of the city; 7. Expenses incurred while seeking medical treatment in a foreign city that meets the conditions of payment of the city's medical insurance fund; 8. Expenses incurred while seeking medical treatment; 7. Expenses for the current year must be declared by January 20 of the following year.

Article 29 of the Social Insurance Law of the People's Republic of China (PRC): The portion of a participant's medical expenses that should be paid by the basic medical insurance fund shall be settled directly by the social insurance administrative department and the medical institutions and pharmaceutical business units. The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.