What is the conceited part of social security and medical insurance?

According to the statistics of the Medical Insurance Bureau, 13.6 1 100 million people in China have purchased medical insurance, and the participation rate is over 95%. Medical insurance includes medical insurance for urban workers or medical insurance for urban and rural residents, and medical insurance for urban and rural residents also includes medical insurance for urban residents and the new rural cooperative medical system.

For ordinary office workers, the company will pay social security, and the medical insurance inside belongs to employee medical insurance. Residents' medical insurance is medical insurance for urban and rural residents who have no work units. Residents need to be insured at their own expense, and the state will subsidize them. Some provinces and cities directly call medical insurance for urban and rural residents, and some provinces and cities will subdivide medical insurance for urban residents and the new rural cooperative medical system.

If you get sick, how much can employee medical insurance report to us? There is a limit to the expenses that can be reimbursed by medical insurance. The treatment expenses must be within the deductible line and the capping line, and the drugs and treatments that meet the medical insurance reimbursement catalogue can be reimbursed in proportion.

Outpatient reimbursement is divided into three stages, namely: accounting stage → self-responsibility stage → sub-responsibility stage. The first account part refers to our personal account. When we go to the clinic, we will advance the expenses that can be reimbursed from our personal account. When the personal account runs out of money, it will enter the conceited section 1500 yuan-to put it bluntly, it means paying more by yourself, at most 1500 yuan. The part exceeding 1.500 yuan will enter the share of our individual and overall account, and will be reimbursed according to the corresponding proportion.

How much can residents' medical insurance report? Because residents' medical insurance is individual contributions+state subsidies, there is no longer a distinction between individual accounts and overall accounts. Both funds are included in the overall planning fund, and both outpatient and hospitalization are reimbursed from this overall planning. Take Shanghai residents' medical insurance as an example. According to different groups of people, if the accumulated medical expenses reach the part outside 300 yuan or 500 yuan within one year, they can be reimbursed in proportion as long as they meet the requirements of medical insurance reimbursement.