Legal analysis: ICU ward expenses can be reimbursed by medical insurance, but generally only about 4%, and the drugs commonly used in ICU are expensive new drugs or imported drugs, which are not reimbursed by medical insurance, so the part of medical insurance reimbursement is very small. If patients get better, they can be transferred to ordinary wards.
The reimbursement rates of medical insurance in ICU are 6%, 55% and 5%.
The medical promotion and medical treatment expenses incurred by insured residents in different types of designated medical institutions, which are above the minimum threshold and below the maximum payment limit, shall be borne according to the following proportions:
1. Designated medical institutions of Class I (including community health service institutions), with 6% paid by the overall fund and 4% borne by individuals;
2. For the second-class designated medical institutions, 55% will be paid by the overall fund and 45% will be borne by individuals;
3, three types of designated medical institutions, the overall fund to pay 5%, individuals bear 5%;
4. The insurance year of residents' medical insurance is calculated according to the natural year. In a natural year, the cumulative maximum payment limit of the overall fund is 25, yuan (including the expenses of diseases specified in hospitalization and outpatient service).
Legal basis: Article 28 of the Social Insurance Law of the People's Republic of China
The medical expenses that meet the standards of the list of drugs, diagnosis and treatment items, medical service facilities and emergency and rescue of basic medical insurance shall be paid from the basic medical insurance fund in accordance with state regulations.
article 29 the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, medical institutions and pharmaceutical trading units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places, so as to facilitate the insured to enjoy the basic medical insurance benefits.