First, the proportion of outpatient reimbursement
Within one year, the reimbursement rate of urban and rural residents in first-class hospitals (including community health service centers) is 30%.
Two. Proportion of hospitalization reimbursement
1. The reimbursement rate of first-class hospitals (community health service centers) is 65%. 2. The reimbursement rate of secondary hospitals is 60%. 3. The reimbursement rate of tertiary hospitals is 55%.
Three. Outpatient qifubiaozhun
Within one year, the deductible line of emergency medical expenses incurred by urban and rural residents in first-class hospitals (including community health service centers) is 800 yuan, and the maximum payment limit is 3,000 yuan.
Four. Qifubiaozhun for hospitalization
1. The first-class hospital (community health service center) has no deductible line. 2. The deductible line of the secondary hospital is 300 yuan. 3. The deductible line of tertiary hospitals is 500 yuan.
Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC), the following medical expenses are not included in the payment scope of the basic medical insurance fund:
(1) shall be paid by the industrial injury insurance fund (2) shall be borne by a third party (3) shall be borne by public medical care (4) overseas medical care.
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.