1, the reimbursement rate of community health service centers and town hospitals is 85%;
2. The reimbursement rate of first-class hospitals (county hospitals and county maternal and child health hospitals) is 75%;
3, secondary hospitals (county people's hospital, county hospital of traditional Chinese medicine) reimbursement rate is 70%;
4. Reimbursement ratio of tertiary hospitals (Binhai Affiliated Hospital, Binzhou People's Hospital, Central Hospital, Third Hospital, etc.). ) It is 55%.
The reimbursement ratio of serious illness medical insurance is as follows:
1, the part of personal compliance medical expenses less than 1.2 million yuan will not be reimbursed.
2. 50% compensation will be given to the part of the compliance medical expenses borne by individuals that exceeds 6.5438+0.2 million yuan (including 6.5438+0.2 million yuan) and is less than 6.5438+0.0 million yuan;
3, 65438+ ten thousand yuan (including 65438+ ten thousand yuan), 200 thousand yuan to 60% reimbursement;
4, 200 thousand yuan (including 200 thousand yuan) above the part to give 65% compensation, each person to give the highest 300 thousand yuan reimbursement.
The reimbursement ratio of hospitalization medical insurance is as follows:
1, 60% reimbursement for treatment in village clinics and village center clinics;
2, the town hospital reimbursement 40%;
3, the secondary hospital reimbursement of 30%;
4, tertiary hospital reimbursement of 20%.
In summary, the proportion of medical insurance reimbursement is 85%. If it exceeds the basic limit, the social security department will reimburse 85% for 0 to 40,000 yuan, 90% for 40,000 to 80,000 yuan, and 95% for more than 80,000 yuan.
Legal basis:
Article 26 of People's Republic of China (PRC) Social Insurance Law
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented 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.