The Qifubiaozhun of the basic medical insurance pooling fund refers to the amount of medical expenses that the insured must pay before the pooling fund begins to pay the medical expenses within the scope of the pooling fund payment, which is also commonly referred to as the "threshold" for the pooling fund payment.

The maximum payment limit of the overall fund is the so-called "capping line", which refers to the upper limit of the medical expenses that the overall fund can pay. Medical expenses exceeding the maximum payment limit shall not be paid by the basic medical insurance.

According to the State Council's "Decision on Establishing the Basic Medical Insurance System for Urban Workers", the Qifubiaozhun of the basic medical insurance pooling fund is controlled in principle at about 10% of the average annual salary of local workers, and the maximum payment limit is controlled in principle at about 4 times of the average annual salary of local workers.