1. Reimbursement ratio 1. Basic medical insurance for employees.

The hospitalization deductibles for insured persons in one medical insurance year are: 800 yuan for working and 600 yuan for retired people; the reimbursement rate for third-level medical institutions is 85%, the reimbursement rate for second-level medical institutions is 88%, and the reimbursement rate for first-level or other medical institutions is 90%.

Retirees pay 90% from the overall fund and 10% from personal contributions.

However, the following conditions must be met: ① Those who receive monthly pensions in Hainan Province, ② Those who have participated in basic medical insurance while working, ③ The payment period (including deemed deemed) is at least 30 years for men and 25 years for women.

(For those who have not reached the payment period, the basic medical insurance benefits they enjoy will be reduced by 3% for each year reduced).

2. Medical insurance for urban residents.

The hospitalization deductible and reimbursement ratio for insured persons within one medical insurance year are: 350 yuan for third-level medical institutions, with a reimbursement ratio of 65%; 300 yuan for second-level medical institutions, with a reimbursement ratio of 75%; 100 yuan for first-level or other medical institutions,

The reimbursement rate is 90%.

3. New rural cooperative medical care.

The hospitalization deductible and reimbursement ratio for participants in one medical insurance year are: RMB 800 for third-level medical institutions, with a reimbursement ratio of 60%; RMB 600 for provincial second-level medical institutions, with a reimbursement ratio of 65%; RMB 300 for city and county second-level medical institutions,

The reimbursement rate is 75%; township-level medical institutions are reimbursed in stages with zero minimum payment, 60% for expenses ≤200 yuan, and 90% for expenses >200 yuan.

2. Reimbursement Process (1) Urban Practitioners: 1. Reimbursement for off-site referrals for individual bills: (1), provide transfer approval form from designated medical institutions (2), review and approval by social security agency (3), hospitalization invoice, hospitalization

Computer list, discharge summary, disease certificate, copy of ID card, bank account number (opening bank and account number) (4), review by supervisors of the social security agency (5), department leader’s approval by the settlement team for settlement while living in other places, on business trips, vacations or visiting relatives

(1), hospitalization invoice, hospitalization computer list, discharge summary, disease certificate, copy of ID card, bank account number (opening bank and account number) (2), review by supervisors of the social security agency (3), approval by department leaders (4

), Settlement Group Settlement 2. Hospitalization reimbursement (1). The insured person will go through the hospitalization procedures at a designated medical institution in this city with his or her ID card (2). When discharged, the relevant materials (computer list, disease course home page, disease certificate, discharge

Summary) Go through hospitalization reimbursement procedures directly at the hospital’s medical insurance office.

3. Out-of-town referral for medical treatment: (1) Referral from a tertiary hospital; (2) Bring your ID card and referral approval form to the medical insurance agency in the insured place for approval; (3) Go to the medical insurance agency in the place of medical treatment for approval

Approval and stamping; (4) Bring the approval form to the designated medical institution for hospitalization; (5) After discharge, return to the insured medical institution with the settlement voucher and invoice for registration; (6) Medical unblocking.

Legal basis: Article 23 of the Social Insurance Law of the People's Republic of China: Employees shall participate in basic medical insurance for employees, and the employer and employees shall jointly pay basic medical insurance premiums in accordance with national regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other people with flexible employment can participate in the basic medical insurance for employees, and individuals must pay the basic medical insurance premiums in accordance with national regulations.