There is a maximum payment limit for medical co-ordination fund payment. The maximum payment limit is the maximum amount that the overall fund can pay. In principle, it should be controlled at about 4 times of the average annual salary of local employees. Not all medical expenses above Qifubiaozhun and below the maximum payment limit shall be borne by the overall fund, and individuals shall also bear part of them. Medical expenses exceeding the maximum payment limit can be solved by other means such as commercial medical insurance. The proportion of the individual burden of medical expenses above the Qifubiaozhun, the maximum payment limit and the Qifubiaozhun, but below the maximum payment limit of the overall planning fund shall be specifically determined by the overall planning area according to the principle of fixed income and expenditure balance. The medical insurance type is the insured of urban workers, and the maximum payment limit of the overall fund is 300 yuan/person/month, including medical expenses and medical expenses. The maximum payment limit of urban and rural residents, minors and students as a whole fund is 1 10,000 yuan/person/year, and only drug expenses can be reimbursed; The maximum payment limit of other people's co-ordination fund is 600 yuan/person/year, and only drug expenses can be reimbursed.

Legal basis:

People's Republic of China (PRC) social insurance law

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.