Proportion of hospitalization reimbursement for Xiamen children's social security card

Legal analysis: the reimbursement rate of Xiamen medical insurance card: the reimbursement rate of outpatient medical expenses above the threshold and below 5,000 yuan in the third, second and first-class designated medical institutions will increase by 5%, that is, from the original 40%, 50% and 60% to 45%, 55% and 65% respectively; Medical expenses above 5000 yuan are still reimbursed according to the original proportion.

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

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.

Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.