Legal analysis: 1. Outpatient reimbursement ratio:
(1) Village clinics and village central clinics reimburse 60% of the reimbursement for visits, with a limit of 10 yuan for prescription drugs per visit, and the health center The doctor's temporary rehydration prescription drug fee limit is 50 yuan.
(2) The town health center reimburses 40% of the fees for each visit, with a limit of 50 yuan for examination fees and surgical fees, and a limit of 100 yuan for prescription drugs.
(3) 30% reimbursement for visits to secondary hospitals, with a limit of 50 yuan for examination fees and surgical fees for each visit, and a limit of 200 yuan for prescription drugs.
(4) 20% reimbursement for visits to tertiary hospitals, with a limit of 50 yuan for examination fees and surgical fees for each visit, and a limit of 200 yuan for prescription drugs.
(5) There is a limit of 1 yuan per prescription attached to the traditional Chinese medicine invoice.
(6) The annual compensation limit for town-level cooperative medical outpatient clinics is 5,000 yuan.
2. Hospitalization reimbursement ratio:
The town health center reimburses 60%; the second-level hospital reimburses 40%; the third-level hospital reimburses 30%.
3. Serious illness reimbursement ratio:
Any inpatient who participates in cooperative medical care will be compensated in stages if the one-time or annual cumulative medical expenses exceed 5,000 yuan, that is, 5,001-10,000 yuan. 65% compensation, 70% compensation for 10,001-18,000 yuan. The annual limit of compensation for town-level cooperative medical inpatient and uremia outpatient hemodialysis, cancer outpatient radiotherapy and chemotherapy is 11,000 yuan.
Legal basis: "Social Insurance Law of the People's Republic of China" Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be borne by the social insurance agency and the medical insurance agency. Institutions and pharmaceutical business units settle directly. The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.