What is the hospitalization rate of medical insurance reimbursement for employees?

The hospitalization proportion of medical insurance reimbursement for employees is as follows:

1, in a first-class and first-class hospital, the minimum threshold is 30,000 yuan, 90% of the basic medical insurance can be paid by the overall fund, and individual employees need to pay 10%. If the floating standard exceeds 30,000-40,000 yuan, its overall fund payment is as high as 95%, and individual employees only need to bear about 5%. Qifubiaozhun in more than 40 thousand yuan, the basic medical insurance fund to pay 97%, individual workers to pay 3%;

2, secondary hospitals, Qifubiaozhun 30000 yuan, 87% of the basic medical insurance can be paid by the overall fund, and the individual contributions of employees reach13%; If the medical expenses exceed 30,000-40,000 yuan, 92% can be paid by the overall fund, and 8% should be paid by individual employees; If the medical expenses exceed 40 thousand yuan, the basic medical insurance can be paid by the overall fund up to 97%, and the individual workers only need to pay 3%;

3. In tertiary hospitals, the minimum threshold is 30,000 yuan for medical expenses, 85% of basic medical insurance can be paid by the overall fund, and individual employees only need to pay15%; If the medical expenses exceed 30,000-40,000 yuan, 90% of the basic medical insurance can be paid by the overall fund, and individual employees only need to pay10%; If the medical expenses exceed 40,000 yuan, the overall fund can pay 95%, and individual employees only need to pay 5%;

4. Among them, the individual contributions of retirees only account for 60% of the contributions of employees.

The scope of medical insurance reimbursement for employees is as follows:

1, the expenses incurred during the period when the new insured fails to issue the social security card;

2 social security card loss, social security card replacement (replacement) card during the cost of medical treatment;

3, in the designated medical institutions without card emergency medical expenses;

4. Medical expenses during the default period;

5. Expenses incurred during the period of manual reimbursement for medical treatment;

6, in line with the conditions of the city's medical insurance fund payment in the field of medical expenses;

7. The annual expenses shall be declared before June 20th of the following year.

To sum up, the proportion of medical insurance reimbursement for employees will vary according to different medical levels and medical expenses.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.