Can social security and medical insurance reimburse serious illness? What is the scope of reimbursement?

Wutongshu Insurance Network will help you answer questions ~

Hello, the coverage of critical illness medical insurance varies from region to region. Among them, critical illness medical insurance covers 20 major diseases such as leukemia, colon cancer, severe mental illness, AIDS opportunistic infection, congenital heart disease, cervical cancer, end-stage renal disease, multidrug-resistant tuberculosis, breast cancer, hemophilia, lung cancer, esophageal cancer, hyperthyroidism, gastric cancer, rectal cancer, cerebral infarction, chronic myeloid leukemia, type I diabetes, acute myocardial infarction and cleft lip and palate.

For some areas, the critical illness of medical insurance for critical illness is not defined by the disease, but by the medical expenses spent by residents. For the expenses that belong to the reimbursement scope of basic medical insurance for local residents, after the reimbursement of basic medical insurance, the remaining medical expenses will be included in the payment scope of serious illness medical insurance for local residents for secondary reimbursement.

This year, the reimbursement rate of medical insurance for serious illness is that medical expenses exceeding the maximum reimbursement limit of basic medical insurance will be reimbursed by social security institutions for 85% below RMB 0 to RMB 40,000, 90% below RMB 40,000 to RMB 80,000 and 95% above RMB 80,000. The maximum reimbursement limit for each medical year is 6,543,800 yuan+0.5 million yuan.