Wuxi social security reimbursement ratio

1, the first visit should be in the community health service center. The threshold for hospitalization expenses is 200 yuan, 90% of which is paid by qualified medical expense fund, 10% is paid by individuals, and students and children are transferred to other medical institutions in the urban area. Other residents in 600 yuan, hospitalized in medical institutions below Grade II, will be paid 75% by eligible medical expense funds and 25% by individuals. The fund of tertiary medical institutions pays 65%, and the individual pays 35%. 3 out of the city, the fund pays 55%, and the individual pays 45%. If the transfer procedures are not handled according to the regulations, the fund will pay 50% of the above standards.

legal ground

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

Article 1 This Law is formulated in accordance with the Constitution for the purpose of adjusting the social insurance relationship, safeguarding citizens' legitimate rights and interests in participating in social insurance and enjoying social insurance benefits, enabling citizens to enjoy the fruits of development and promoting social harmony and stability.

Article 2 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 in case of old age, illness, industrial injury, unemployment and maternity.

Article 3 The social insurance system adheres to the principles of wide coverage, basic protection, multi-level and sustainability, and the level of social insurance should be compatible with the level of economic and social development.

Article 4 Employers and individuals who pay social insurance premiums according to law in People's Republic of China (PRC) have the right to inquire about payment records and personal rights and interests records, and ask social insurance agencies to provide social insurance consultation and other related services. Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.