1. The specific reimbursement standards are: 50% for secondary hospitals, 50% for first-class hospitals, 60% for township hospitals and 70% for village hospitals;

2. The upper limit of hospitalization reimbursement for each participant is 6.5438+0.5 million yuan per year. The expenses incurred by participating patients in hospitalization in designated medical institutions shall be reimbursed according to the expenses recognized by the new rural cooperative medical system and the reimbursement ratio of designated medical institutions at different levels;

3. The reimbursement rate of the county-level designated medical institutions of the new rural cooperative medical system in Guiyang is: 60% in tertiary hospitals, 70% in primary hospitals, 75% in secondary hospitals and 80% in township hospitals.

What is medical insurance?

1. Medical insurance is social medical insurance, which is a social welfare insurance system to compensate workers or urban and rural residents for economic losses caused by disease risks;

2. Establish a medical insurance fund through payment by employers and individuals and state financial subsidies. After the insured has incurred medical expenses, he shall reimburse the insured for the medical expenses according to a certain proportion, and give the insured economic compensation to avoid or reduce the economic risks caused by illness and treatment. Social medical insurance includes basic medical insurance for urban workers and basic medical insurance for urban and rural residents.

To sum up, the reimbursement rate: 55% for tertiary hospitals; The reimbursement rate of secondary hospitals is 65%; The reimbursement rate of first-class hospitals is 75%. Reimbursement ratio: 85% of employees with a minimum threshold of 55,000 yuan will be reimbursed; 90% of retirees; For medical expenses ranging from 55,000 yuan to 6,543.8+0.5 million yuan, the reimbursement ratio of employees and retirees is 80%.

Legal basis:

Article 29 of People's Republic of China (PRC) Social Insurance Law

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.

Article 30

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.