1, reimbursement ratio of employee medical insurance hospitalization:
(1) 85% of hospitalization expenses are between 1300 yuan-30,000 yuan;
(2) The reimbursement rate between 30,000 yuan and 40,000 yuan is 90%;
(3) The reimbursement rate between 40,000 yuan and10,000 yuan is 95%;
(4 4) 10/00000 yuan to 300000 yuan reimbursement ratio is 85%;
2, the proportion of residents' medical insurance reimbursement:
(1) The reimbursement rate of first-class hospitals is 65%;
(2) 80% of the second-level hospitals are reimbursed for more than 6,000 yuan.
Check the proportion of medical insurance reimbursement:
1, local query
Insured persons can directly bring their identity documents and residents' medical insurance cards to the service hall of the local social security bureau to print the payment list, and can inquire about relevant information in detail. This way is more direct, suitable for those who can't surf the Internet and help themselves by telephone, and those who have time are more suitable for the elderly at a certain age.
2. Telephone enquiry
Insured persons can call the Social Security Bureau directly 12333 for enquiry. According to the voice prompts, you need to enter the social security card number and account password. This query method is also convenient and fast, and it is the first choice of many people;
3. Online inquiry
Online query is suitable for people who know computer operation and don't have much leisure time. First, find the website of the local social security bureau online, open the website page, and enter personal information such as personal social security card account number, inquiry password and ID number, so that you can find your latest account information conveniently and quickly.
To sum up, the three most commonly used types of medical insurance reimbursement are general drug purchase, outpatient service and hospitalization. Different categories have different reimbursement rates, methods and procedures.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, 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.