legal subjectivity:

1. Upper limit of annual reimbursement for outpatient medical insurance for urban workers: 2, yuan. Deductible line: 1,8 yuan for on-the-job personnel, with reimbursement rate starting from 7%. Retirees 13 yuan, reimbursement ratio: 85%. Upper limit of annual reimbursement for hospitalization: 3, yuan. The deductible line: regardless of employees or retirees, the first hospitalization starts from 13 yuan, and the reimbursement ratio starts from 85%. Second hospitalization, from 65 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 in the previous year shall be calculated by stages and paid cumulatively. Under 5, yuan, the reimbursement rate starts from 5%, above 5, yuan, and the reimbursement rate starts from 6%, with no ceiling. 2. Upper limit of annual reimbursement for outpatient medical insurance for urban and rural residents: 3, yuan. Deductible line: The reimbursement rate is 55% from 1 yuan, a first-class hospital. The reimbursement rate is 5% from 55 yuan, the second-level and above hospitals. Hospitalization: 2, yuan. Deductible: from 15 yuan for children, from 3 yuan for adults, and the reimbursement rate is 75%. Remarks: The above expenses do not include expenses that are not included in medical insurance, such as out-of-pocket expenses and out-of-pocket expenses. Also, the registration fee (medical service fee) is not included in the deductible line and the capping line. Article 28 of the Social Insurance Law stipulates that medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations. According to the basic requirements for the payment of basic medical insurance benefits in China, the insured person who goes to the medical insurance institution to reimburse the medical expenses incurred by his own medical treatment generally meets the following conditions: (1) The insured person must go to the designated medical institution of basic medical insurance for medical treatment and purchase drugs, or purchase drugs from the designated retail pharmacy determined by the social insurance institution with the medical prescription issued by the doctor in the designated hospital. (2) The medical expenses incurred by the insured in the process of seeing a doctor must conform to the scope and payment standards of the basic medical insurance drug list, diagnosis and treatment items, and medical service facilities standards, so as to be paid by the basic medical insurance fund according to regulations. (3) Among the medical expenses that the insured meets the scope of payment of basic medical insurance, the part above the Qifubiaozhun of the social medical co-ordination fund and below the maximum payment limit shall be paid by the social medical co-ordination fund in a unified proportion.