The medical insurance card can reimburse medical expenses as follows:

1. Medical expenses incurred in outpatient clinics that meet the regulations will be reimbursed according to the following proportions, and the remainder shall be paid by the individual:

(1) For the part of medical expenses less than 1,000 yuan, 35% will be reimbursed;

(2) For the part of medical expenses above 1,000 yuan (including 1,000 yuan) but less than 5,000 yuan, 100% will be reimbursed. 45%;

(3) For medical expenses above 5,000 yuan (including 5,000 yuan) and less than 10,000 yuan, 55% will be reimbursed;

(4) Medical expenses For the portion above 10,000 yuan (including 10,000 yuan), 65% will be reimbursed.

2. Qualified medical expenses incurred during hospitalization will be reimbursed according to the following proportions, and the remainder will be paid by the individual. The medical expenses for multiple hospitalizations within the year will be accumulated:

(1 ) For medical expenses less than 10,000 yuan, the reimbursement rates for medical treatment in third-level, second-level and first-level medical institutions are 55%, 65% and 75% respectively;

( 2) For the part of medical expenses above 10,000 yuan (inclusive) and less than 20,000 yuan, the reimbursement ratio is 60%, 70% and 10% respectively for medical treatment in third-level, second-level and first-level medical institutions. 80%;

(3) For medical expenses above 20,000 yuan (including 20,000 yuan), if treated in third-level, second-level and first-level medical institutions, the reimbursement ratio is 100% respectively. 65, 75 and 85 percent.

The applicable scope of the medical insurance card is as follows:

1. For purchasing medicine: insured persons can use the medical insurance card to pay when buying medicine at designated pharmacies;

2. For reimbursement: If you go to the hospital for medical treatment, whether outpatient or inpatient, if you reach the medical insurance deductible and are within the scope of medical insurance reimbursement, you can use the medical insurance card for reimbursement;

3. For medical treatment: Shenhe When people get sick, they can use their medical insurance card and medical insurance handbook to register and seek treatment at designated hospitals.

To sum up, after the basic medical insurance co-ordination fund pays proportionally, the excess part of the personal burden exceeding 8,000 yuan will be reimbursed by the critical illness insurance fund at a rate of 55%.

Legal basis:

Article 23 of the "Social Insurance Law of the People's Republic of China"

Employees shall participate in employee basic medical insurance, which shall be provided by the employer Units and employees must pay basic medical insurance premiums together in accordance with national regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexible employment personnel can participate in the basic medical insurance for employees, and individuals must pay for the basic medical insurance in accordance with national regulations. fee.