Legal analysis: the second reimbursement of medical insurance means that after the reimbursement of basic medical insurance, some funds such as retirees and military disability subsidies will report the amount that needs to be paid by individuals again according to the corresponding proportion. In fact, it is the reimbursement of supplementary medical insurance. That is to say, the hospitalization expenses that have been settled in the hospital within one year (including family beds and medical treatment outside the city), the accumulated part of individual out-of-pocket expenses MINUS the part of class C expenses 1 10,000 yuan or more, can enjoy the second subsidy from the medical insurance fund.

First, outpatient emergency expenses reimbursement. The minimum payment for large medical assistance (outpatient and emergency) is 2000 yuan for employees and 0 yuan for retirees 1.300 yuan. The accumulated outpatient and emergency expenses of employees within one year are less than 2,000 yuan, and the retirees 1.300 yuan shall be paid by the insured from their personal accounts. If the amount reaches above the deductible within a natural year, a large medical mutual assistance system can be applied.

2. Reimbursement of hospitalization expenses According to the regulations, when the basic medical insurance is used to pay hospitalization expenses for the first time in a year, the deductible amount of working and retired personnel is 1.300 yuan. The medical expenses for the second and subsequent hospitalization are determined according to the deductible line of 50%, which is 650 yuan. The maximum annual payment limit (hospitalization expenses) of the basic medical insurance pooling fund is currently 70,000 yuan. The individual contribution ratio of retirees is 60% of the individual contribution ratio of employees, but the part below the minimum deductible is the same, and all of them are paid by individuals. The standard of hospitalization reimbursement is related to the level of the medical institution where the insured person is located. Note: Outpatient service and hospitalization are two deductible lines.

3. How much does the hospitalization cost exceed the maximum payment limit? If the hospitalization expenses of the insured exceed the maximum payment limit, the excess expenses will be reimbursed according to the relevant standards of large-scale medical mutual assistance, that is, 70% will be paid by large-scale medical mutual assistance funds and 30% by individuals. Within one year, the accumulated maximum payment amount of large-scale medical mutual assistance is 654.38+10,000 yuan.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.