Proportion of reimbursement in Shanghai medical insurance card 3A hospitals

Legal analysis: 1. Outpatient service: 20% reimbursement for treatment in tertiary hospitals, with each examination fee and operation fee limited to 50 yuan and prescription fee limited to 200 yuan; Chinese medicine invoice with prescription, each paste limit 1 yuan; The annual compensation limit for rural cooperative medical clinics is 5000 yuan. 2. Hospitalization: reimbursement scope: medical expenses, auxiliary examination, electrocardiogram, X-ray fluoroscopy, filming, laboratory tests, physical therapy, acupuncture, CT and nuclear magnetic resonance 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan). The elderly over 60 years old are hospitalized in health centers, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan. Third-level hospitals are reimbursed 30%.

Legal basis: Regulations of People's Republic of China (PRC) Municipality on Basic Medical Insurance for Urban Workers.

Twenty-seventh employees of the employer who pay the basic medical insurance premiums in accordance with these regulations shall enjoy the basic medical insurance benefits.

Twenty-eighth personal accounts are used to pay medical expenses beyond the scope of the overall fund; If the personal account is insufficient to pay, it shall be borne by me.