Service description: You have been buying medical insurance for so long, do you know how to calculate the medical insurance deductible? What is the reimbursement ratio? What is the maximum reimbursement amount? Next, let’s highlight the key points for you! 1. The deductible is set according to the hospital level in the city.

The fee is 100 yuan for hospitals of grade 1 and below, 200 yuan for the city's second-level hospitals, 300 yuan for the city's tertiary hospitals, 400 yuan for medical institutions outside the city that have made referrals or filed records in accordance with regulations, and 400 yuan for cases where referrals or records have not been made in accordance with regulations.

The registration fee is 1,000 yuan.

If the insured person is transferred to different hospitals for hospitalization, the deductibles will be calculated separately.

2. Reimbursement ratio for the insured person’s hospital stay above the deductible line. The insured person’s basic medical expenses incurred during hospitalization and the local supplementary medical expenses above the deductible line shall be paid according to the following provisions: 1. The insured person has received monthly employee benefits in this city.

For pension insurance benefits and basic medical insurance premiums paid at 11.5%, the payment ratio is 95%; 2 For participants in the first level of basic medical insurance who pay basic medical insurance premiums at 8% and for participants in the second level of basic medical insurance who do not

For those who receive employee pension insurance benefits on a monthly basis in this city, the payment ratio is 90%; 3 Participants in the third level of basic medical insurance who are hospitalized in the city's first-level hospitals, second-level hospitals, third-level hospitals, and hospitals outside the city according to regulations

, the payment ratios are 85%, 80%, 75%, and 70% respectively.

Inpatient medical expenses incurred for emergency rescue in non-accounting hospitals due to work or business trips shall be paid at 90% of the hospital payment standard of the hospital where the patient was treated.

Note: For basic medical expenses and local supplementary medical expenses incurred by insured persons who are hospitalized in designated medical institutions outside the city or non-designated medical institutions outside the city without making referrals or filing in accordance with regulations, 90% of the standard shall be paid respectively.

, 70% payment.

3. The maximum reimbursement amount for basic medical expenses and local supplementary medical expenses 1. The current basic medical insurance pooling fund can reimburse up to 486,000 yuan in the current medical insurance year.

If the basic medical insurance has been continuously insured for more than 72 months, the maximum payment limit of the basic medical insurance pooling fund in each medical insurance year is 6 times the average salary of the city's employees on the job in the previous year.

Calculated based on the average monthly salary of Shenzhen employees in the previous year of 6,753 yuan/month in 2016, it is: 6,753 yuan x 12 months

The time to participate in basic medical insurance shall be based on the following standards: 2. The local supplementary medical insurance fund can reimburse up to 1 million yuan in the current medical insurance year. If the basic medical insurance has been continuously insured for more than 72 months, the maximum payment limit of the local supplementary medical insurance fund is

1 million yuan.

The payment limit of the local supplementary medical insurance fund in each medical insurance year shall be implemented according to the following standards based on the time the insured has continuously participated in the local supplementary medical insurance: Note! In the current medical insurance year, if the medical insurance payment amount exceeds 1.486 million yuan, the local supplementary medical insurance

The insurance fund can still continue to pay 50%! 3. If you pay for critical illness insurance and your out-of-pocket payment exceeds 10,000 yuan during the medical insurance year, then 70% of the excess can be reimbursed.

In the same social medical insurance year, if the medical expenses incurred by the insured person while hospitalized are within the scope of the social medical insurance catalog according to regulations and the part that should be paid by the insured person exceeds 10,000 yuan in total, the excess part shall be paid by the undertaking agency 70%

%, and there is no cap on the benefits.

In the same social medical insurance year, if the insured person suffers from serious or serious diseases and uses domestic drugs, 70% of the expenses incurred by the undertaking institution shall be paid, and the maximum payment amount shall not exceed 150,000 yuan.