Scope and proportion of social security reimbursement in Shenzhen

Legal analysis: Shenzhen's basic medical insurance is divided into three forms: basic medical insurance 1 file (comprehensive medical insurance), second file (hospitalization medical insurance) and third file (migrant workers' medical insurance). The reimbursement rate of Shenzhen social security policy is 92%, the reimbursement rate of basic medical insurance is above 80%, and the land compensation is around 7%. Plus critical illness insurance, the reimbursement rate in all policies is 92%.

Legal basis: Article 47 of the Measures of Shenzhen Municipality on Social Medical Insurance: The personal account of the insured person in the first file of basic medical insurance is used to pay the basic medical expenses of the insured person's outpatient service, the local supplementary medical expenses, and the expenses of purchasing drugs in the medical insurance catalogue at designated retail pharmacies with the prescriptions of doctors in designated medical institutions in this city. The part that is not paid in the personal account shall be paid by the individual.

If the primary insured of basic medical insurance has been insured continuously for 1 year, and the outpatient basic medical expenses and local supplementary medical expenses paid by individuals in the same medical insurance year exceed 5% of the average salary of employees in this city last year, 70% of the excess will be paid by the basic medical insurance serious illness pooling fund or local supplementary medical insurance fund according to regulations, and 80% will be paid by the insured over 70 years old.

The insured who enjoys the treatment specified in the preceding paragraph does not enjoy the treatment specified in Article 49.