Legal analysis: Medical expenses incurred by insured residents who are hospitalized in different types of designated medical institutions that meet the prescribed requirements, and are above the minimum payment standard and below the maximum payment limit, shall be borne in accordance with the following proportions: First-class designated medical institutions (including community health service institutions)

, the overall fund pays 60% and the individual bears 40%; the second-category designated medical institutions, the overall fund pays 55% and the individual bears 45%; the third-category designated medical institutions, the overall fund pays 50% and the individual bears 50%; residents’ medical insurance

The annual calculation is based on a natural year. In a natural year, the cumulative maximum payment limit of the overall fund is 25,000 yuan (including inpatient and outpatient prescribed disease expenses).

Legal basis: "Social Insurance Law of the People's Republic of China" Article 28 Medical expenses that comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue expenses shall be deducted from the basic medical insurance fund in accordance with national regulations.

Pay.