The highest reimbursement rate for general outpatient service of Nanjing residents' medical insurance is 5%, and the highest reimbursement rate for employees is 7%. First, the proportion of reimbursement for general outpatient service

the proportion of residents who report to the general outpatient service

1. In a natural year, the expenses for "residents' empty time" to see the outpatient service within 2 yuan shall be borne by individuals, and the expenses between 2 and 9 yuan shall be paid by 6% in the community hospital treatment fund and 5% in other hospitals;

2. For residents over 8 years old, 65% will be paid in community hospitals and 55% in other hospitals, and the expenses above 9 yuan will be borne by individuals.

3. "Students and children" will pay 6% of the medical expenses for outpatient service -4 yuan.

4. 5% will be paid by the fund for treatment in other hospitals, and the expenses above 4 yuan will be borne by the individual.

note: the outpatient expenses incurred by insured residents in other places shall be borne by individuals, and the fund will not subsidize them.

Second, the proportion of reimbursement for serious illness in outpatient department

(1) The proportion of reimbursement for serious illness in outpatient department of residents

5% will be paid for the part from RMB 1, to RMB 4,;

55% shall be paid for the part of 2, yuan or more to 6, yuan;

6% of the 3, yuan to 8, yuan;

4, yuan to 1, yuan, 65%;

7% will be paid for the part above RMB 1, yuan.

6. "Students and Children" fund pays 85%.

(2) 6% will be paid for the proportion of reimbursement for serious illness in the outpatient department of workers

from RMB 1, to RMB 4, (including RMB 4,, the same below);

2. 65% of the amount from RMB 4, to RMB 6,;

7% will be paid for the part of 3, yuan or more to 8, yuan;

75% shall be paid for the part of 4, yuan or more to 1, yuan;

8% will be paid for the part above RMB 1, yuan.

III. "Resident" hemophilia

According to the light, medium and heavy types, the fund payment limits are 1,, 5, and 1, respectively, and the proportion of fund payment within the limits is 8%.

IV. Proportion of reimbursement for serious illness in hospital

Proportion of reimbursement for serious illness in hospital for residents

1. The threshold for "residents" is 1, 5 and 3 yuan respectively, and the proportion of fund payment is 65%, 85% and 9% respectively;

2. The minimum threshold for "students and children" is 5, 4 and 3 yuan in the third, second and first-class hospitals respectively, and the proportion of fund payment is 8%, 9% and 95% respectively.