I paid social security for half a year. Can I be reimbursed for a serious illness? What is the limit?

Reimbursement scope of serious illness medical insurance: medical expenses exceeding the maximum payment limit of the basic medical co-ordination fund will be reimbursed by the social security department for 85% below RMB 0-40 thousand, 90% below RMB 40-80 thousand and 95% above RMB 80 thousand. The maximum payment limit for each medical year is 6.5438 yuan +0.5 million yuan.

According to the relevant regulations, local enterprises (hereinafter referred to as enterprises) and their employees and retirees who are applicable to cities, districts and counties within the administrative area of this Municipality can enjoy medical insurance for serious illness. Retirees who do not pay the basic medical insurance premium and continue to enjoy the basic medical insurance benefits are not in the "serious illness medical insurance coverage".

Serious illness medical care can be divided into two types from the form of insurance. One is serious illness social insurance, which is a special medical insurance fund set up to ensure the medical needs of urban workers for major diseases. It is used to pay the medical expenses that the insured person has accumulated over the maximum payment limit of the basic medical insurance for urban workers during the year. The other is the serious illness medical treatment in commercial insurance, which is the major illness protection that the insurance company underwrites for a specific insurer according to the insurance clauses.

It should be noted that the explanations of these two serious diseases in the scope of medical insurance are not exactly the same, and consumers should have a choice when insuring and using them.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.