Social security reimbursement standard

Legal analysis: If urban residents are hospitalized for more than two times in a settlement year, starting from the second hospitalization, the Qifubiaozhun fee will no longer be charged. Transfer or hospitalization for more than two times, make up the difference of Qifubiaozhun in accordance with the provisions of transfer or hospitalization again. Students and children, in a settlement year, incurred medical expenses below 6,543,800 yuan+0.8 million yuan, which are within the scope of reimbursement. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%. At least 70 years old and above. In a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occur. The threshold of tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 65%.

In other towns, within a settlement year, medical expenses below 654.38+10,000 yuan that meet the scope of reimbursement occurred. The threshold for tertiary hospitals is 659 yuan, the reimbursement ratio is 50%, and the upper limit is 2,000 yuan; The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.

Legal basis: Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid from the basic medical insurance fund in accordance with state regulations.