Legal analysis: 1. Outpatient medical expenses: within the payment range of basic medical insurance (within the maximum payment amount from the deductible line to the capping line), after deducting the deductible line 1800 yuan from the "self-pay one" part, it is calculated as 20% (25% for model workers and extremely poor employees). 2. Hospitalization medical expenses: within the scope of basic medical insurance payment (within the maximum payment amount from the deductible line to the capping line), the "self-pay one" part of the expenses borne by the employees is deducted for the first hospitalization 1.300 yuan (650 yuan is deducted for the second hospitalization; 650 yuan was deducted for the first hospitalization of poor workers, and 325 yuan was deducted for the second hospitalization. After the deductible, the mutual aid is calculated at 20% (25% for model workers and poor workers). 3. Outpatient and inpatient medical expenses above the capping line: Out-of-pocket expenses that still occur within the scope of medical insurance after the "self-paying one" expenses of outpatient and inpatient employees reach the capping line of basic medical insurance can enjoy 40% of the mutual aid fund from the capping line to 50,000 yuan, with the maximum reimbursement amount of 20,000 yuan; 50,000 yuan to 654.38+million yuan, you can enjoy 60% mutual aid, and the maximum reimbursement amount is 30,000 yuan; 100000 yuan to 150000 yuan, you can enjoy 80% mutual aid, and the maximum reimbursement amount is 40000 yuan.

Legal basis: Article 23 of the Social Insurance Law of People's Republic of China (PRC), employees shall participate in the basic medical insurance for employees, and both employers and employees shall pay the basic medical insurance premium according to the provisions of the state. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.