What is the scope and proportion of social security reimbursement in Shanghai?

Legal analysis: outpatient service: 20% reimbursement for medical treatment in tertiary hospitals, with the limit of each examination fee and operation fee in 50 yuan and the limit of prescription drug fee in 200 yuan; Chinese medicine invoice with prescription, each paste limit 1 yuan; The annual compensation limit for rural cooperative medical clinics is 5000 yuan. Hospitalization: reimbursement scope: medicine expenses: auxiliary examination: ECG, X-ray fluoroscopy, photography, laboratory test, physiotherapy, acupuncture, CT, nuclear magnetic resonance and other examination expenses 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan). The elderly over 60 years old are hospitalized in health centers, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan. Third-level hospitals are reimbursed 30%. Social security reimbursement system refers to the behavior of social insurance to compensate employees and residents for medical expenses, maternity expenses and industrial and commercial treatment expenses in proportion. Social security reimbursement mainly includes medical insurance reimbursement, maternity insurance reimbursement and work-related injury insurance reimbursement.

Medical insurance in social security is basic medical insurance. Reimbursement scope: general outpatient and emergency expenses incurred by the insured in designated hospitals or specialized hospitals, Chinese medicine hospitals and 3A hospitals selected by the insured. Reimbursement ratio: if the emergency expenses of general outpatient service exceed 2,000 yuan in a natural year, 50% will be paid by some large medical mutual aid funds above 2,000 yuan, and 50% will be paid by individuals themselves. For retirees who have accumulated more than 1.300 yuan and more than 1.300 yuan, 70% will be paid by the large medical mutual aid fund over 70 years old, 30% by individuals, 80% by the large medical mutual aid fund over 70 years old and 20% by individuals. The maximum payment limit in a natural year is 20000 yuan.

Legal basis: Article 64 of People's Republic of China (PRC) Social Insurance Law includes basic endowment insurance fund, basic medical insurance fund, industrial injury insurance fund, unemployment insurance fund and maternity insurance fund. All social insurance funds shall be accounted for according to the types of social insurance, and a unified national accounting system shall be implemented. The social insurance fund is earmarked for special purposes, and no organization or individual may occupy or misappropriate it. The basic old-age insurance fund will gradually implement national overall planning, and other social insurance funds will gradually implement provincial overall planning. The specific time and steps shall be stipulated by the State Council.