Legal analysis: 1. The minimum payment line for urban and rural residents' medical insurance in the city's tertiary hospitals is adjusted from 700 yuan to 800 yuan, and the reimbursement ratio is 70%; the minimum payment line for referrals to hospitals outside the province and city is 2,000 yuan, and the reimbursement ratio is 65%;

The minimum payment line outside the province is 2,500 yuan, and the reimbursement ratio is 60%; 2. Urban and rural residents’ medical insurance, the fixed hospitalization subsidy for childbirth (including cesarean section) in hospitals in three counties in one city is adjusted from 800 yuan to 1,000 yuan; 3. Urban and rural residents’ medical insurance and serious illness insurance

The reimbursement ratio for the minimum payment range of 100,000 to 200,000 yuan (including 200,000 yuan) has been increased from 75% to 80%; the reimbursement ratio for the segment above 200,000 yuan has been increased from 80% to 85%, and the cap for serious illness is 300,000 yuan.

Legal basis: "Bengbu City Urban and Rural Resident Basic Medical Insurance and Critical Illness Insurance Security Benefits Implementation Measures" Article 27 Within an insurance year, the accumulated legal medical expenses borne by the insured exceed the critical illness insurance threshold, the critical illness insurance fund

Proportional reimbursement by cost segment: (1) The minimum payment threshold is calculated once per insurance year, and the minimum payment threshold for critical illness insurance is 15,000 yuan.

(2) For the period above the threshold of critical illness insurance and within 50,000 yuan (including 50,000 yuan), the reimbursement ratio is 60%; for the period between 50,000 and 100,000 yuan (including 100,000 yuan), the reimbursement ratio is 65%; for the period between 100,000 and 200,000 yuan

(including 200,000 yuan), the reimbursement rate is 80%; for the period above 200,000 yuan, the reimbursement rate is 85%.

(3) The upper limit of critical illness insurance is 300,000 yuan.

(4) Reimbursement amount of critical illness insurance = (annual accumulated medical expenses of insured patients’ hospitalization and special chronic disease outpatient services – negative list expenses – reimbursed amount of basic medical insurance – basic medical insurance threshold – critical illness insurance threshold) × segmented reimbursement ratio.

At the same time, we will increase preferential payments for the extremely poor, subsistence allowance recipients, and poor people, lowering the critical illness insurance threshold by 50% compared with ordinary insured residents, increasing the reimbursement rate by 5 percentage points, and canceling the cap.