The proportion of reimbursement depends on local regulations and is not uniform. You should understand that medical insurance (whether universal insurance or company's) has a deductible line, commonly known as threshold fee. This part of the money needs to be paid by yourself, and the rest can be reimbursed according to the regulations of medical insurance. The scope of reimbursement for universal health insurance is the same as that for local employees. Medical insurance can reimburse more examination, surgery, hospitalization and other expenses of top three hospitals. A: Generally speaking, it is 80%, but it depends on whether there are self-funded drugs. Generally, those who have been hospitalized for surgery will be reimbursed 20,000 first, and the rest will be settled separately.

Can be reimbursed, as long as the cost of surgery is within the scope of medical insurance, it can be reimbursed according to the relevant proportion.

1. The medical expenses above 1800 yuan can only be reimbursed after the on-the-job employees see a doctor in the emergency department of the hospital, and the reimbursement rate is 50%.

2. Retirees under the age of 70,1.Expenses above 300 yuan can be reimbursed, and the reimbursement rate is 70%.

3. Retirees over 70 years old,1.Expenses above 300 yuan can be reimbursed by 80%. Basic medical insurance co-ordination fund within one year.

At present, the maximum payment is 70,000 yuan.

4, more than 40000 yuan to the maximum payment limit, 95% can be reimbursed, employees only need to pay 5%.

5. The proportion paid by retirees is on-the-job.

60% of employees, but below the minimum threshold, are paid by individuals.

First, the proportion of outpatient and emergency expenses reimbursement

1. The medical expenses above 1800 yuan can only be reimbursed after the on-the-job employees see a doctor in the emergency department of the hospital, and the reimbursement rate is 50%.

2. Retirees under the age of 70,1.Expenses above 300 yuan can be reimbursed, and the reimbursement rate is 70%.

3. Retirees over 70 years old,1.Expenses above 300 yuan can be reimbursed by 80%.

Second, the proportion of hospitalization expenses reimbursement

The maximum annual payment limit (hospitalization expenses) of the basic medical insurance pooling fund is currently 70,000 yuan.

1, the standard of hospitalization reimbursement is related to the level of the hospital where the insured person is located. If you live in a tertiary hospital, the employee pays 15%, which is 85% of the reimbursement, from the minimum threshold to 30,000 yuan.

2, 30,000 yuan to 40,000 yuan, the employee's individual contribution 10%, 90% reimbursement;

3, more than 40000 yuan to the maximum payment limit, 95% can be reimbursed, employees only need to pay 5%.

4. The individual contribution ratio of retirees is 60% of the on-the-job (i.e. the above) employees, but all below the threshold is paid by individuals.

I hope the above content can help you. If in doubt, please consult a professional lawyer.

Legal basis:

Article 30 of People's Republic of China (PRC) Social Insurance Law

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

(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.