What is the amount of medical insurance co-ordination

General outpatient: for participants whose type of medical insurance is urban workers, the maximum payment limit of the integrated fund is 300 yuan/person/month, including medication and consultation fees. For urban and rural residents, the maximum payment limit of the integrated fund for minors and school students is 1,000 yuan/person/year, which can only reimburse the cost of medicines; for others, the maximum payment limit of the integrated fund is 600 yuan/person/year, which can only reimburse the cost of medicines. Outpatient Designated Chronic Diseases (Outpatient Chronic Diseases): For participants whose medical insurance type is urban workers, the maximum payment limit of the integrated fund is 200 yuan/category of disease/month, without rolling over or accumulating. For urban and rural residents, the maximum payment limit of the co-ordination fund is RMB 50/category of disease/month, deposited Outpatient Specified Chronic Diseases (Outpatient Special): there are different maximum payment limits for different diseases, and participants can consult the Social Security Bureau or check the hospital's social security bulletin for information. Hospitalization: Hospitalization has a starting line, which is RMB 1,600 for active employees and flexibly employed persons among urban workers, and RMB 1,120 for retirees, with an annual cumulative maximum payment limit of RMB 445,500 for both of them from the integrated fund, and an annual maximum payment limit of RMB 222,700 for major disease benefits.　　The starting line for urban and rural residents is 1,000 yuan, with an annual cumulative maximum payment limit of 182,000 yuan for the integrated fund, and an annual maximum payment limit of 120,000 to 180,000 yuan for major disease benefits.

Medical expenses incurred above the starting-payment threshold for hospitalization and emergency observation room stay for observation, as well as outpatient major illness or family hospital bed medical expenses incurred by an employee in a medical insurance year, which are below the maximum payment limit, will be paid by the coordinated fund in accordance with the stipulated payment ratio.

Legal basis:Decision on the Establishment of a Basic Medical Insurance System for Urban Employees"

The starting standard of the basic medical insurance fund is in principle controlled at about 10% of the average annual salary of local employees, and the maximum payment limit is in principle controlled at about 4 times the average annual salary of local employees.