medical insurance, referred to as medical insurance, is a kind of social insurance. The reimbursement ratio of medical insurance is:
1. On-the-job employees: first-class hospitals, with 9% reimbursement from the overall fund and 1% paid by individuals; Secondary hospitals, 85% of the overall fund reimbursement, and 15% of the individual pays; Third-class hospitals, 8% of the overall fund reimbursement, 2% of the individual pays. 2. Retirees: first-class hospitals, 93% of the overall fund reimbursement, 7% of the individual pays; In the second-level hospital, 89.5% is reimbursed from the overall fund and 1.5% is paid by the individual; In Grade III and Grade A hospitals, 86% is reimbursed from the overall fund and 14% is paid by individuals.
3. Migrant workers (migrant workers' medical insurance is purchased in Guangzhou for foreign accounts): First-class hospitals, with 72% reimbursement from the overall fund and 28% paid by individuals; Secondary hospitals, 68% of the overall fund reimbursement, and 32% of the individual pays; In Grade III and Grade A hospitals, 64% is reimbursed from the overall fund and 36% is paid by individuals. Medical insurance reimbursement, simply put, is the cost you pay for medical treatment, which is partly borne by the state or unit, and the part of the burden is called reimbursement. China's medical insurance is divided into two parts: individual account and social pooling fund, which are jointly funded by units and individuals according to the prescribed proportion to ensure the basic medical needs of citizens. Among them, the overall fund is used to pay the hospitalization expenses, the personal account is used to pay the outpatient and emergency expenses and the drug purchase expenses of designated retail pharmacies, and the expenses that need to be borne by individuals in the specific items of hospitalization and outpatient services are also paid by personal accounts, and if the funds in personal accounts are insufficient, they are paid by individuals.
Legal basis:
Article 28 of the Social Insurance Law
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 29
the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, medical institutions and pharmaceutical trading 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.