the general formula of medical insurance reimbursement is as follows: reimbursement amount = [total treatment cost-deductible line-self-funded part] _ reimbursement ratio (7%-9%) Note: deductible line means that medical expenses can only be reimbursed if they exceed the minimum limit, and deductible line varies from region to region, generally 1-2 yuan. The maximum amount of reimbursement, that is, the amount of money reimbursed, cannot exceed the maximum amount, and there are also differences in different regions, generally hundreds of thousands. When we are sick, we will encounter three situations: outpatient service, hospitalization and serious illness: general outpatient and emergency service: headache and brain fever, and hang up a number to pat our ass and leave after seeing the disease. Hospitalization: It takes a period of concentrated treatment, such as childbirth and heart surgery. The expenses include various beds, diagnosis and treatment, surgery and nursing expenses during hospitalization. Serious illness: such as cancer, uremia, organ transplantation, etc., medical expenses are huge and need special reimbursement. Outpatient service, hospitalization and serious illness all have their own deductible line, maximum reimbursement limit and reimbursement ratio, and we will explain them one by one. (1) Outpatient reimbursement ratio: Outpatient can be commonly understood as minor illness, and hospitalization is not required. First of all, the money in a personal account can be used directly as cash. For example, if you have a headache or fever, you can go to a designated medical institution or a designated retail pharmacy to buy medicine, and you can directly swipe the money in our personal account of medical insurance card. Secondly, if the medical expenses in one year are more than the minimum deductible (different standards in different regions, 18 yuan in Beijing), medical insurance can reimburse us in proportion. The higher the hospital level, the lower the reimbursement rate. For example, Beijing stipulates that the reimbursement rate for outpatient service in community hospitals is 9%, and that for non-community hospitals is 7%. (2) Proportion of reimbursement for hospitalization: general illness, surgery to the designated hospital for hospitalization. The medical expenses of hospitalization will be automatically linked to our social pooling account of medical insurance, and the calculation method of final reimbursement is similar to that of outpatient service above. There is a ceiling in the world: it is generally four times the local average annual salary, and Beijing is now 1,. There is a starting line below: below this deductible starting line, it is not reported. The starting line for hospitalization in Beijing is 13 yuan. There is a self-funded part in the middle: expensive imported drugs not covered by social security insurance are not reported. After removing the starting line and the self-funded part, the remaining part is reimbursed in proportion. Beijing adopts a progressive reimbursement system, that is, the more you spend, the greater the reimbursement ratio. < P >: 1. How to pay medical insurance? Not everyone can pay medical insurance, and it is conditional to pay medical insurance. To open a medical account for yourself, you have to have a job and become a company employee. In this way, the unit will help you pay medical insurance. As long as your salary is higher than the minimum payment base stipulated by the state, the unit will help you pay 9% of your monthly salary, and you will pay 2% of your salary yourself. You have to pay for 25 years before you can enjoy free medical care for life after retirement. Here, I will focus on children's medical insurance. When children are young, they are ill and hospitalized. We must pay children's medical insurance. The specific method is that parents submit an application report to the Social Security Bureau with their baby's Birth Certificate, and they can enjoy medical insurance just like adults by paying 2-5 yuan per year (depending on the proportion of payment in different places). If you are a freelancer and have not signed a labor contract with any unit, the state allows you to pay medical insurance as long as you have a certain legal income and are under 6 years old (female is under 55 years old). It's just that there is no company to help you pay, and you have to bear the full 11% ratio. There is no minimum payment period, but it must be paid every year.