What is the proportion of social security reimbursement?

The social security reimbursement ratio is as follows:

1, a third-class first-class hospital, the part above the deductible line to the highest payment limit is paid by 90%.

2, secondary hospitals, Qifubiaozhun above to 1000 yuan to pay 85%, 1000 yuan above to pay 90% of the maximum limit.

3, tertiary hospitals, Qifubiaozhun above 5 thousand yuan by 80%, more than 5 thousand yuan to the highest payment limit by 85%.

4. Auxiliary examination items: 70% of the examination expenses of blood and imaging examination shall be paid by the medical insurance fund.

5. Hospitalization: The reimbursement rate for hospitalization varies from 70% to 95% according to the regulations of hospital level.

The characteristics of social security are as follows:

1. The objective basis of social insurance is the risks existing in the labor field, and the object of insurance is the individual workers;

2. The subject of social insurance is specific. Including workers and employers;

3. Social insurance is compulsory;

4. The purpose of social insurance is to maintain the reproduction of labor force;

The insurance fund comes from the contributions and financial support of employers and workers. Insurance coverage is limited to employees, excluding other social members. The insurance coverage is limited to all kinds of risks in labor risks, excluding other risks such as property and economy.

In summary, the proportion of social security reimbursement is limited. Under normal circumstances, the social security fund will only reimburse the medical expenses that meet the requirements, excluding the part paid by individuals and the part beyond the scope of reimbursement. Therefore, when enjoying medical services, we should pay attention to the qualifications of hospitals and doctors, whether they are within the scope of social security reimbursement, etc., so as to avoid personal expenses arising from non-compliant medical services.

Legal basis:

Article 1 of People's Republic of China (PRC) Social Insurance Law

In order to standardize the social insurance relationship, safeguard the legitimate rights and interests of citizens to participate in social insurance and enjoy social insurance benefits, enable citizens to enjoy the fruits of development and promote social harmony and stability, this Law is formulated in accordance with the Constitution.

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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 get material help from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.