Under normal circumstances, individuals can apply for serious illness relief if their out-of-pocket expenses are more than 5,000 yuan, but local policies are different. You can consult relevant local departments before reimbursement.

1, urban and rural subsistence allowances, courageous wounded people hospitalized due to illness (injury), after being reimbursed by the new rural cooperative medical insurance, residents' medical insurance and serious illness insurance, they will be given assistance according to the proportion of 60%, and the maximum amount of one assistance is 20,000 yuan;

2, key entitled groups (excluding 1-6 disabled soldiers, 7- 10 disabled soldiers) were hospitalized due to illness, and after being reimbursed by the new rural cooperative medical system, residents' medical insurance, serious illness insurance and special relief departments, each person was given a maximum of 20,000 yuan per year;

3. Low-income families with difficulties and families with major diseases who cannot afford them are hospitalized due to illness. After being reimbursed by the new rural cooperative medical system, residents' medical insurance and serious illness insurance, assistance will be given according to the proportion of 20%, and the maximum ceiling line for one assistance is 1 10,000 yuan.

4. After the amount of hospitalization assistance for urban and rural subsistence allowances reaches the ceiling line, the out-of-pocket expenses will start from 1 10,000 yuan, and the part exceeding 1 10,000 yuan will be given a second assistance at a rate of 30%, with no more than 40,000 yuan per person per year; After the amount of hospitalization assistance for other recipients reaches the top line, the out-of-pocket expenses will start from 1 10,000 yuan, and the part that exceeds 1 10,000 yuan will be given a second assistance at a rate of 20%, and each person will not exceed 20,000 yuan per year.

5. Rural five-guarantee households: refers to those who have no legal dependents, or whose dependents are unable to support and have no source of income. Generally, these people are lonely old people, disabled people or orphans. Urban "three no-workers": people who have no breadwinner, no source of income and no ability to work, just like the five-guarantee households. Urban and rural low-income households: poor family economic conditions, unable to seek medical treatment due to serious illness. Reduce the number of retired workers: those who enjoy living allowance at the same time can apply for serious illness relief.

Legal basis:

Opinions of the General Office of the State Council on the Full Implementation of Serious Illness Insurance for Urban and Rural Residents

Second, improve the financing mechanism of serious illness insurance.

(1) Scientifically calculate the financing standard. According to the local economic and social development level, the high medical expenses caused by serious illness, the financing ability and payment level of basic medical insurance, and the level of serious illness insurance protection, all localities scientifically and prudently calculate funds and reasonably determine the financing standard of serious illness insurance.

(2) stabilize the source of funds. Draw a certain proportion or quota from the basic medical insurance fund for urban and rural residents as a serious illness insurance fund. In areas where the basic medical insurance fund for urban and rural residents has a balance, use the balance to raise a serious illness insurance fund; Areas with insufficient balance or no balance shall be arranged in the funds raised every year. Improve the multi-channel financing mechanism of basic medical insurance for urban and rural residents to ensure the sustainable development of the system.