Proportion of hospitalization medical reimbursement

The proportion of reimbursement for medical hospitalization is not less than 60%.

Basic medical insurance, the reimbursement rate of medical expenses for employees during hospitalization is not less than 60%. At the same time, medical insurance also has a special reimbursement policy for some special diseases. For example, medical insurance will have a higher reimbursement rate for the treatment of chronic diseases.

Serious illness insurance, the proportion of medical expenses reimbursement for employees during hospitalization is not less than 50%. At the same time, for some high medical expenses, medical insurance will also provide additional reimbursement policies. For example, medical insurance will have a higher reimbursement rate for the treatment costs of major diseases such as tumors.

The scope of medical insurance reimbursement includes the following contents:

1, outpatient medical expenses. Including outpatient registration fee, medical treatment fee, examination fee, treatment fee, operation fee, special treatment fee, Chinese medicine decoction pieces fee, etc. ;

2. Hospitalization medical expenses. Including hospital care fees, bed fees, operation fees, examination fees, treatment fees, medicine fees, laboratory fees, etc. ;

3, special outpatient medical expenses. Including medical treatment, examination, treatment, surgery, laboratory tests, radiation, nuclear medicine and other expenses;

4, reproductive health care costs. Including pre-pregnancy, pregnancy, postpartum examination, treatment, surgery, drugs, materials and other expenses;

5, chronic disease treatment costs. Including outpatient treatment expenses and hospitalization expenses for chronic diseases. Chronic diseases include diabetes, hypertension, coronary heart disease, chronic obstructive pulmonary disease and malignant tumor.

6, special disease treatment costs. Including AIDS, hepatitis and other special diseases;

7. Other related expenses. Including medical assistance, medical accident compensation, medical care equipment, rehabilitation and other related expenses.

To sum up, the scope of medical insurance reimbursement may be different due to factors such as regions, policies and types of medical insurance, and the specific reimbursement standards and scope need to be implemented in accordance with relevant local regulations. At the same time, individuals need to pay social security fees in accordance with relevant regulations in order to enjoy medical insurance reimbursement.

Legal basis:

Article 2 of People's Republic of China (PRC) Social Insurance Law

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.

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.