Legal analysis: If you are sick, you need to be treated. As for the scope of reimbursement, there are specialized responsible agencies and personnel to review it.

The insurance coverage is as thick as a small Xinhua dictionary.

Therefore, it is helpful to know some precautions. The urban residents basic medical insurance fund reimburses the following: 1. Medical expenses for hospitalization; 2. Medical expenses that comply with the regulations on special diseases for urban residents; 3. Other expenses that meet the regulations.

The basic medical insurance for urban residents is a medical insurance system for urban employees, that is, non-employed people. When it is implemented, it is subdivided into several types of groups and treated differently in terms of payment, reimbursement ratios and other matters.

Minors (0-18 years old): If citizens within this category want to participate in urban resident basic medical insurance, they need to provide a copy of the household registration information page of the head of the household and the insured person. Under normal circumstances, each person needs to pay an annual fee.

Insurance fee of 35 yuan.

Chaoyang City has included newborns in the coverage of urban residents' medical insurance since last year, and stipulates that newborns insured within three months of birth only need to pay an insurance premium of 15 yuan per year, and they can enjoy the coverage one month from the date of payment.

treatment.

Adults (18-60 years old): If this group of people is a new insured person, they need to provide a copy of their ID card, a copy of the first page of the household register and the insured person page, and two one-inch photos. Each person needs to pay an annual premium of 136 yuan.

.

Insured persons over 60 years old: The required documents and premiums are the same as those for adults. The difference between the two is that the reimbursement ratio of medical expenses is different. The reimbursement ratio for adult insured persons is 60%, and the reimbursement ratio for insured persons over 60 years old is 70%.

.

Minimum living allowance insured persons: If the insured persons are enjoying the minimum living allowance, each minor needs to pay an annual premium of 25 yuan, each adult needs to pay an annual premium of 66 yuan, and each insured person over 60 years old needs to pay an annual premium of 56 yuan.

Yuan.

Severely disabled insured persons (with a disability certificate of level 2 or above): minors need to pay 15 yuan per year, adults need to pay 56 yuan per year, and senior insured persons over 60 years old need to pay 56 yuan per year.

Those who participate in urban basic medical insurance must bring the above documents to the community where they live to go through relevant procedures and pay at a designated bank. Generally, they can enjoy medical insurance benefits after the waiting period.

At present, the reimbursement ratio of basic medical insurance premiums for urban residents is 60%, of which 70% is for insured persons over 60 years old, and the maximum annual payment is 95,000 yuan. Currently, Chaoyang City, Liaoning Province has provided maternity insurance, accident insurance, outpatient insurance and

Chronic diseases are included in the coverage of residents' medical insurance, and no additional premiums are required.

Maternity insurance enjoys a normal reimbursement ratio, and the reimbursement ratio of accident insurance is 50%. Situations such as drinking, fighting, traffic accidents, emergencies, and accidents without responsible persons are not covered by accident insurance.

The initial payment standard for outpatient coordination is 40 yuan, the second and subsequent minimum payment standards are 20 yuan, the minimum payment standard for outpatient coordination in a natural year is 200 yuan, and the maximum amount of medical expenses that can be paid by the overall planning fund in a natural year is per

1,000 yuan per person per year.

Legal basis: Article 2 of the "Social Insurance Law of the People's Republic of China" The state establishes basic pension insurance, basic medical insurance, work-related injury insurance, unemployment insurance, maternity insurance and other social insurance systems to protect citizens in the event of old age, illness, work-related injury,

The right to obtain material assistance from the state and society in accordance with the law in cases of unemployment, childbirth, etc.

Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical insurance and basic medical insurance for urban residents shall be implemented in accordance with national regulations.

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 paid from the basic medical insurance fund in accordance with national regulations.