What is the national medical insurance deductible?

The deductible line of national medical insurance is as follows:

1. Medical insurance for urban workers: annual reimbursement limit for outpatient service: 20,000 yuan. Deductible: On-the-job personnel 1.800 yuan, with the reimbursement rate starting from 70%. Retirees 1300 yuan, the reimbursement rate is 85%. Upper limit of annual reimbursement for hospitalization: 300,000 yuan. Deductible line: No matter whether employees or retirees are hospitalized for the first time1.From 300 yuan, the reimbursement rate is 85%. Second hospitalization, since 650 yuan, reimbursement rate: 85%. Major diseases: The part of self-paid medical expenses that exceeds the per capita disposable income of urban residents in this city last year shall be calculated by stages and paid cumulatively. Under 50,000 yuan, the reimbursement rate starts from 50%, and over 50,000 yuan, the reimbursement rate starts from 60%, with no upper limit.

2. Medical insurance for urban and rural residents: annual reimbursement limit for outpatient service: 3,000 yuan. The deductible line: level-1 hospital 100 yuan, and the reimbursement rate is 55%. Reimbursement rate from 550 yuan, 50% for hospitals of level 2 and above. Hospitalization: 200,000. Deductible: 75% for children 150 yuan and adults in 300 yuan.

Medical insurance reimbursement standards are as follows:

1. Drug expenses: The reimbursement standard for drug expenses is generally determined according to the classification, grade and price of drugs in the medical insurance catalogue. Under normal circumstances, the medical insurance fund can reimburse more than 50% of the drug expenses, and the specific proportion depends on factors such as drug types and medical insurance types;

2. Treatment expenses: The reimbursement standard of treatment expenses is generally determined according to the classification, grade, price and other factors of medical treatment items in the medical insurance catalogue. Under normal circumstances, the medical insurance fund can reimburse more than 50% of the treatment expenses, and the specific proportion depends on factors such as the type of diagnosis and treatment project and the type of medical insurance.

3. Hospitalization expenses: The reimbursement standard for hospitalization expenses is generally determined according to the classification, grade and price of hospitalization items in the medical insurance catalogue. Under normal circumstances, the medical insurance fund can reimburse more than 70% of hospitalization expenses, and the specific proportion depends on factors such as the type of hospitalization project and the type of medical insurance.

To sum up, the specific medical insurance reimbursement standards may be different due to different policies and regulations. It is recommended to consult the relevant staff of the local social security bureau or consult local policies and regulations.

Legal basis:

People's Republic of China (PRC) social insurance law

second

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 receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.

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.