2. Retired employees: The outpatient service fee is 1.300 yuan, that is, only the part that exceeds 1.300 yuan is reimbursed, with 70% for those under 70 years old and 80% for those over 70 years old.
3. Maximum amount: No matter what kind of people, the maximum amount of outpatient and emergency medical expenses is 20,000 yuan.
First, 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 within the scope of outpatient co-ordination fund are reimbursed at the rate of 60%. The maximum annual payment limit for individuals of the overall fund is 400 yuan.
2. Special diseases: In a medical insurance year, the deductible for outpatient service of special diseases is 400 yuan, and the proportion of reimbursement for medical expenses meeting the prescribed treatment scope is the same as that for general hospitalization.
Two, the new rural cooperative medical insurance:
1, 60% of the medical expenses of village clinics and village center clinics are reimbursed, and the prescription drug fee limit for each visit 10 yuan, and the prescription drug fee limit for temporary rehydration of hospital doctors is 50 yuan.
2. Reimbursement of 40% for medical treatment in town health centers, with the limit of examination fee and operation fee for each visit, and the limit of prescription fee 100 yuan.
3, the secondary hospital reimbursement of 30%, each examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan.
4, tertiary hospital reimbursement of 20%, each visit examination fee and operation fee limit 50 yuan, prescription drug fee limit 200 yuan.
5. Traditional Chinese medicine invoices are accompanied by prescriptions, with a limit of 1 yuan.
6, the township cooperative medical outpatient compensation limit is 5000 yuan.
7. Special diseases: In a medical insurance year, the deductible for outpatient service of special diseases is 400 yuan, and the proportion of reimbursement for medical expenses that meet the prescribed treatment scope is the same as that for general hospitalization.
Legal basis:
Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities and emergency and rescue medical expenses standards, and shall be paid from the basic medical insurance fund in accordance with state regulations.
"People's Republic of China (PRC) Social Insurance Law" Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.