The medical insurance reimbursement ceiling line refers to the maximum payment limit of the medical insurance fund, that is, the reimbursement amount that the insured can get from the medical insurance fund within one year. Medical expenses exceeding the cap line can be solved by participating in supplementary medical insurance and commercial medical insurance.
The part exceeding the top line of basic medical insurance can be included in the scope of serious illness insurance for urban and rural residents according to the actual burden of medical expenses. Serious illness insurance is the expansion and extension of the basic medical security system, which mainly pays the high medical expenses of seriously ill patients on the basis of basic medical insurance payment. After the insured residents are paid by the basic medical insurance, the expenses beyond the deductible line of serious illness insurance shall be included in the scope of payment of serious illness insurance according to the regulations.