Maximum reimbursement limit of social medical insurance

Legal analysis: the maximum reimbursement amount of medical insurance for urban residents: outpatient reimbursement: 2000 yuan; Hospitalization reimbursement: 6.5438+0.7 million yuan. Maximum reimbursement amount of medical insurance for urban workers. Outpatient reimbursement: 20,000 yuan; Hospitalization reimbursement: 300,000 yuan. Supplementary note: 1, the maximum reimbursement amount refers to the accumulated payment in a medical insurance year. 2. The maximum reimbursement limit of medical insurance for urban workers is 300,000 yuan, including 654.38+million yuan for the basic medical insurance pooling fund and 200,000 yuan for the accumulated large mutual fund.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

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

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.