Proportion of reimbursement for serious illness medical insurance

Legal analysis: 1, 55% of the accumulated amount is more than10.2 million yuan but less than 30,000 yuan (inclusive); 2, 30,000 yuan more than 6,543,800 yuan+10,000 yuan (inclusive) the following part pays 65%; 3 more than 65.438 billion yuan to pay 75%, the annual maximum payment limit is not less than 300 thousand yuan in principle. 4. When calculating the cumulative personal burden of serious illness insurance, the amount of medical assistance enjoyed by poor patients in that year is not deducted. We will provide effective protection and accurate assistance to patients with excessive personal burden after reimbursement of basic medical insurance and compensation for serious illness insurance, precise poverty alleviation targets, and poor people who have no money to abandon medical treatment.

Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC), the following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.