The ratio of hospitalization insurance in tertiary hospitals under Beijing’s medical insurance is as follows: 1. For the portion of the minimum payment standard up to 30,000 yuan, the overall fund will pay 85%, and employees will pay 15%; 2. For the portion exceeding 30,000 to 40,000 yuan, the overall fund will pay

90% is paid, and employees pay 10%; 3. For the part exceeding 40,000 yuan, the overall fund pays 95%, and employees pay 5%.

(1) Medical expenses incurred in secondary hospitals: 1. For the part where the minimum payment standard is up to 30,000 yuan, the overall fund will pay 87%, and the employee will pay 13%; 2. For the part exceeding 30,000 to 40,000 yuan, the overall fund will pay

92% is paid, and employees pay 8%; 3. For the part exceeding 40,000 yuan, the overall fund pays 97%, and employees pay 3%.

(2) Medical expenses incurred in first-level hospitals and family beds: 1. For the part from the minimum payment standard to 30,000 yuan, the overall fund pays 90% and the employee pays 10%; 2. For the part exceeding 30,000 yuan to 40,000 yuan

, the overall fund pays 95%, and employees pay 5%; 3. For the part exceeding 40,000 yuan, the overall fund pays 97%, and employees pay 3%.

(3) Medical expenses incurred in first-level hospitals and family beds: 1. For the part from the minimum payment standard to 30,000 yuan, the overall fund pays 90% and the employee pays 10%; 2. For the part exceeding 30,000 yuan to 40,000 yuan

, the overall fund pays 95%, and employees pay 5%; 3. For the part exceeding 40,000 yuan, the overall fund pays 97%, and employees pay 3%.

(4) The personal payment ratio for retirees is 60% of the employee payment ratio.

The mutual aid fund for large medical expenses will pay for large medical expenses that comply with the provisions of basic medical insurance in accordance with the following methods: 1. For the employee’s cumulative outpatient and emergency medical expenses exceeding 1,800 yuan in one year, the mutual aid fund for large medical expenses will pay 50%,

Personal payment is 50%.

2. For retirees whose accumulated outpatient and emergency medical expenses exceed 1,300 yuan in one year, for retirees under the age of 70, 70% of large medical expenses will be paid by mutual aid funds and 30% by individuals; for retirees over 70 years old, for large amounts,

Mutual aid funds pay 80% of medical expenses, and individuals pay 20%.

3. The maximum amount of large-amount medical expense mutual aid funds that can be paid cumulatively for outpatient and emergency medical expenses for employees and retirees in one year is 20,000 yuan.

4. Inpatient medical expenses for employees and retirees that exceed the maximum payment limit of the basic medical insurance pooling fund in a year (excluding the part below the minimum payment standard and personal burden), malignant tumor radiotherapy and chemotherapy, kidney dialysis, and post-kidney transplant services

For outpatient medical expenses of anti-rejection drugs, 70% of large medical expenses are paid by mutual aid funds and 30% by individuals.

However, the maximum cumulative amount of mutual aid funds for large medical expenses paid in one year is 100,000 yuan.

Legal basis: Article 28 of the Social Insurance Law. Medical expenses that comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be paid from the basic medical insurance fund in accordance with national regulations.

Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit.

The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.