two different reimbursement rates are set according to different medical expense ranges and payment standards.

first, the low rate of medical insurance

the low rate of medical insurance refers to the reimbursement ratio set by medical insurance when paying for some common medical services with relatively low expenses. These items usually include general outpatient service, essential drugs, routine examination, etc. Due to the relatively low cost of these projects, the reimbursement rate of low-rate medical insurance is also relatively low, generally between 5% and 8%. The setting of low magnification is aimed at encouraging patients to use medical resources rationally and reducing the burden of medical insurance funds.

Second, the high rate of medical insurance

Corresponding to the high rate are some medical services with high cost and difficult treatment, such as hospitalization, surgery and special examination. These projects usually need more medical resources and technical support, so the cost is relatively high. In order to ensure the treatment needs of patients, medical insurance has set a high reimbursement ratio, that is, high magnification, when paying for these items. The reimbursement rate of high rate can usually reach more than 8%, and even reach 1% in some special circumstances.

iii. adjustment and change of medical insurance ratio

the setting of medical insurance ratio is not static, but will be adjusted according to the actual situation of medical resources, the treatment needs of patients and the income and expenditure of medical insurance funds. According to the requirements of medical reform and economic development, the government will adjust the medical insurance ratio in time to better protect patients' medical rights and interests.

To sum up:

The low rate and high rate of medical insurance are two different reimbursement rates set by medical insurance when paying for medical services with different cost ranges. Low magnification is suitable for low-cost medical services, aiming at encouraging patients to use medical resources reasonably; High magnification is suitable for projects with high cost and difficult treatment to ensure the treatment needs of patients. The setting and adjustment of medical insurance ratio is an important part of medical insurance system, aiming at better protecting patients' medical rights and interests.

Legal basis:

Article 28 of the Social Insurance Law of the People's Republic of China

stipulates:

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.

Article 3 stipulates:

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(1) Those that should be paid from the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) It shall be borne by public health;

(4) seeking medical treatment abroad.