Legal subjectivity: According to the relevant laws of our country, active employees should pay for basic medical insurance, which is generally paid by the employer and the employee simultaneously. Only those who meet certain conditions can enjoy basic medical insurance benefits.

What is the general reimbursement ratio of medical insurance? 1. Outpatient reimbursement ratio (1) Employee medical insurance: 1. Only medical expenses of more than 1,800 yuan can be reimbursed for active employees after they go to the hospital's outpatient department or emergency department. The reimbursement ratio is 90% in community hospitals.

, 70% for other designated hospitals, with a maximum limit of 20,000 yuan.

2. Retirees under the age of 70 can be reimbursed for expenses exceeding 1,300 yuan, and the reimbursement ratio is 85% (non-community hospitals) and 90% (community hospitals).

3. For retirees over 70 years old, any hospital can reimburse 90% of the cost of more than 1,300 yuan.

4. Regardless of the type of person, the maximum amount of large medical expenses paid for outpatient and emergency services is 20,000 yuan.

(2) College students: 1. For medical expenses less than 1,000 yuan, 35% will be reimbursed; 2. For medical expenses above 1,000 yuan (including 1,000 yuan) and less than 5,000 yuan, 45% will be reimbursed; 3. Medical expenses above 5,000 yuan

(Inclusive of 5,000 yuan) and above, but less than 10,000 yuan, 55% will be reimbursed; 4. For medical expenses above 10,000 yuan (inclusive of 10,000 yuan), 65% will be reimbursed.

2. Employee medical insurance: hospitalization expense reimbursement ratio 1. Minimum payment standard: Within a medical insurance year, the minimum payment standard for the first hospitalization is 1,300 yuan, and the second and subsequent hospitalizations are 650 yuan.

2. Reimbursement ratio: The method of segmented calculation and cumulative payment is adopted, and the payment ratio is calculated separately according to the hospital level.

3. Payment limit: The cumulative maximum payment limit of the basic medical insurance pooling fund in one year is 100,000 yuan, and the cumulative maximum payment limit of large-amount mutual aid funds is 200,000 yuan, with a maximum of 300,000 yuan.

Legal provisions: Article 29 of the "Social Insurance Law of the People's Republic of China" stipulates: "The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be borne by the social insurance agency, medical institutions, and pharmaceutical operators.

Direct settlement by the unit. The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate the insured persons to enjoy basic medical insurance benefits. Legal Objective: Article 29 of the Social Insurance Law of the People's Republic of China.

The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly by the social insurance agency and the medical institution and pharmaceutical business unit. The social insurance administrative department and the health administrative department shall establish a settlement system for medical expenses in other places to facilitate the settlement.

Insured persons enjoy basic medical insurance benefits. Article 28 of the "Social Insurance Law of the People's Republic of China" complies with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses in accordance with national regulations.

Paid from the basic medical insurance fund.