Medical insurance for urban workers:

1. On-the-job workers: The amount of outpatient service is 2 yuan, that is, out of the medical expenses incurred by outpatient service, the part exceeding 2 yuan will be reimbursed, and the reimbursement ratio is 5%;

2. Retired employees: The amount of outpatient service is 13 yuan, that is, out of the medical expenses incurred by outpatient service, only those exceeding 13 yuan will be reimbursed. For those under 7 years old, the reimbursement rate is 7%, while for those over 7 years old, the reimbursement rate is 8%.

3. Maximum amount: No matter what kind of people, the maximum amount of outpatient and emergency medical expenses is 2, yuan.

Medical insurance for urban residents:

1. General outpatient service: In a medical insurance year, there is no deductible line for general outpatient service, and the medical expenses paid by the outpatient co-ordination fund will be reimbursed at the rate of 6%, and the annual maximum personal payment limit of the co-ordination fund is 4 yuan.

2. Special diseases: In a medical insurance year, the amount of outpatient exemption for special diseases is 4 yuan, and the proportion of reimbursement for medical expenses that meet the prescribed treatment scope is the same as that of ordinary hospitalization.

new rural cooperative medical insurance:

1. 6% of the medical expenses of village clinics and village center clinics are reimbursed, and the prescription drug fee for each visit is limited to 1 yuan, and the prescription drug fee for temporary rehydration of doctors in health centers is limited to 5 yuan.

2. 4% reimbursement for medical treatment in the town health center, with the limit of each examination fee and operation fee in 5 yuan and prescription drug fee in 1 yuan.

3. The reimbursement for medical treatment in secondary hospitals is 3%. The limit of examination fees and operation fees for each visit is 5 yuan, and the limit of prescription drug fees is 2 yuan.

4. tertiary hospitals will be reimbursed 2%, with the limit of each examination fee and operation fee in 5 yuan and the limit of prescription drug fee in 2 yuan.

5. The invoice of traditional Chinese medicine is attached with a prescription with a limit of 1 yuan per paste.

6. The annual compensation limit for outpatient service of town-level cooperative medical care is 5, yuan.

7. Special diseases: In a medical insurance year, the amount of outpatient exemption for special diseases is 4 yuan, and the proportion of reimbursement for medical expenses that meet the prescribed treatment scope is the same as that of ordinary hospitalization.

medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the payment of employers and individuals. After the insured person suffers from medical expenses, the medical insurance institution will give him some economic compensation.

Legal Basis

Social Insurance Law of the People's Republic of China

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, work injury insurance, unemployment insurance and maternity insurance to protect citizens' rights to receive material assistance from the state and society in case of old age, illness, work injury, unemployment and maternity.