1, yes. There is an upper limit on the amount of medical insurance reimbursement;

2. Social basic medical insurance is divided into two categories, namely, medical insurance for urban workers and medical insurance for urban and rural residents. The reimbursement limits of these two kinds of social medical insurance do not mean that there is a limit on the amount of hospitalization each time, but there is a limit on the natural year;

3. In our country, the medical insurance reimbursement limit has local regulations, but it is not uniform throughout the country. Upper limit of annual reimbursement for outpatient medical insurance for urban workers: 20,000 yuan. Deductible: On-the-job personnel 1.800 yuan, with the reimbursement rate starting from 70%. Retirees 1300 yuan, the reimbursement rate is 85%. Upper limit of annual reimbursement for hospitalization: 300,000 yuan. Deductible line: No matter whether employees or retirees are hospitalized for the first time1.From 300 yuan, the reimbursement rate is 85%. Second hospitalization, since 650 yuan, reimbursement rate: 85%. Major diseases: The part of self-paid medical expenses that exceeds the per capita disposable income of urban residents in this city last year shall be calculated by stages and paid cumulatively. Under 50,000 yuan, the reimbursement rate starts from 50%, and over 50,000 yuan, the reimbursement rate starts from 60%, with no upper limit.

The functions of employee medical insurance are as follows:

1, the insured can enjoy the right to basic medical insurance for life after completing the payment period, and can enjoy medical reimbursement and medical insurance benefits after retirement. The advantages are as follows: the part of the medical expenses of the insured who should be paid by the basic medical insurance fund is directly settled by social insurance agencies, medical institutions and pharmaceutical business units;

2. The basic medical insurance system for employees is a social medical insurance system that guarantees the basic medical rights of employees according to law. Enforced by laws and regulations, the basic model of combining social pooling medical funds with individual medical accounts is implemented. Like pension, work injury, unemployment and maternity insurance, it is the basic insurance item of social insurance;

3. The basic medical insurance treatment standard for employees is as follows: the employee basic medical insurance pooling fund and individual account shall be accounted for separately according to their respective payment scope, and shall not be crowded with each other.

To sum up, the suspension period is generally 15 days to 3 months, and the specific situation will be handled separately.

Legal basis:

Article 2 of People's Republic of China (PRC) Social Insurance Law

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Article 28

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