Generally speaking, the proportion of reimbursement after individuals pay medical insurance is partly paid by the medical insurance fund and partly paid by individuals. The proportion of individual reimbursement for medical insurance for urban workers and urban and rural residents is as follows:

1. Medical insurance for urban employees: the reimbursement rate for employees is 30 %- 80%, which may be slightly different in different provinces and cities. Specifically, under normal circumstances, the medical insurance fund pays 80% of the expenses, and individual employees pay 20% of the expenses;

2. Medical insurance for urban and rural residents: the proportion of reimbursement for individual residents is 50 %- 70%. Specifically, the medical insurance fund pays 50% to 70% of the expenses, and individual residents pay 30% to 50% of the expenses.

The reimbursement process after individuals pay medical insurance is generally as follows:

1. See a doctor: When you see a doctor or buy medicine in a medical institution, you need to show your medical insurance card, ID card and other relevant documents;

2. Preparation of reimbursement materials: after seeing a doctor, you need to go to a medical institution to obtain medical records, doctor's orders, prescriptions, receipts and other related materials, and fill in the relevant reimbursement application form;

3. Submit reimbursement application: submit the prepared reimbursement materials and application forms to the local social security bureau or medical insurance center for reimbursement application. You can also choose to apply for reimbursement online;

4. Review the reimbursement application: the local social security bureau or medical insurance center will review the submitted reimbursement application, and after the approval, the reimbursement will be credited to the personal bank account.

To sum up, the medical insurance policy and reimbursement ratio may be different in different regions, and the specific situation should be subject to local policies. At the same time, the scope and amount of medical insurance fund payment are also affected by different policies, and the specific reimbursement ratio and amount will also change due to different medical projects.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.