1. reimbursement ratio of medical insurance for serious illness in new rural cooperative medical system. On the basis of limited expenses, the actual reimbursement rate for major diseases has increased to 70%. The Ministry of Civil Affairs will give another 20% compensation to the poor people within its assistance scope, and the sum of the two can reach 90%. In addition, except for rural residents suffering from 22 major diseases, their hospitalization and serious illness clinics are included in the reimbursement policy of the new rural cooperative medical system, and the part of the annual personal expenses accumulated over 20,000 yuan is given assistance according to the proportion of 60%; The annual accumulated expenses exceeding the reimbursement policy of the new rural cooperative medical system are more than 40,000 yuan, and assistance is given according to the proportion of 20%;

2. The reimbursement ratio of employee's serious illness medical insurance and the payment limit of employee's serious illness medical insurance reimbursement are different in different parts of China due to different levels of local economic development. However, in recent years, all provinces and cities in China have greatly increased the payment limit for reimbursement of medical insurance for employees with serious illness. From the initial tens of thousands of yuan, it increased to hundreds of thousands or even hundreds of thousands of yuan. The scope of medical expenses paid by large medical insurance is the same as that of basic medical insurance, and the payment ratio is 100%. The top line of large funds is 500 thousand.

Major diseases in medical insurance coverage are as follows:

1, seeing a doctor in a non-designated hospital without approval (except for emergency rescue);

2. Suffering from occupational diseases, work-related injuries or recurrence of old injuries;

3. Injuries caused by traffic accidents;

4. Injuries caused by my illegal acts;

5. Food poisoning caused by accidents;

6. receiving treatment for suicide;

7. Injuries caused by medical accidents;

8, according to the provisions of the state and the city should take care of medical expenses.

To sum up, medical insurance for major diseases can be divided into two types. One is social security medical insurance for major diseases, which is a medical insurance fund established to protect the medical needs of urban workers for major diseases. It is used to pay the medical expenses incurred by the insured in purchasing the basic medical insurance for urban workers during the year that exceed the maximum payment limit of the basic medical insurance. The other is commercial medical insurance for major diseases, in which the insurance company is responsible for the major diseases agreed by the insured according to the insurance clauses. It should be noted that these two kinds of critical illness medical insurance are not exactly the same, so you should choose when applying and using them.

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.