Generally speaking, the economic development situation of different regions is different, so the reimbursement ratio is also different. The following is an explanation of the insurance ratio of Beijing employee medical insurance.

After enrolling in medical insurance, if you are an active employee, you can only reimburse for medical expenses exceeding 1,800 yuan after going to the hospital's outpatient clinic or emergency room, and the reimbursement rate is 50%.

For retirees under the age of 70, expenses above 1,300 yuan can be reimbursed, and the reimbursement rate is 70%.

For retirees over 70 years old, 80% of expenses above 1,300 yuan can be reimbursed.

Regardless of the type of person, the maximum amount for outpatient and emergency medical expenses is 20,000 yuan.

For example, if you are an active employee and the cost of outpatient treatment is 2,500 yuan, then 50% of the 700 yuan part can be reimbursed, which is 350 yuan.

If it is hospitalization expenses, when the basic medical insurance is used for payment for the first time in 2009, the minimum payment amount is 1,300 yuan for both working people and retirees.

As for the medical expenses for the second and subsequent hospitalizations, the minimum payment standard is determined at 50%, which is 650 yuan.

The maximum payment amount of the basic medical insurance pooling fund (hospitalization expenses) in one year is 70,000 yuan.

The standard of hospitalization reimbursement is related to the level of the hospital where the insured person lives. For example, if the insured person lives in a third-level hospital, from the minimum payment standard to 30,000 yuan, the employee pays 15%, that is, 85% is reimbursed; from 30,000 yuan to 4

For expenses of 10,000 yuan, employees pay 10% and 90% are reimbursed; for expenses exceeding 40,000 yuan and up to the high payment limit, 95% can be reimbursed, and employees only need to pay 5%.

The proportion of personal payment for retirees is 60% of that of active (the above-mentioned) employees, but anything below the minimum payment standard is paid by the individual.

Different places have different pooled medical insurance payment ratios, but most are around 60-70%. If you have any doubts about the pooled medical insurance payment ratio in your location, you can check with the Social Security Bureau or hospital.

3. What are the standards for overall medical insurance payment? 1. The amount of payment from the overall fund = (hospital medical expenses - self-paid items - minimum payment standard) × payment ratio from the overall fund.

2. The overall fund refers to the part of the payment that is not credited to the account and needs to be entered into the overall fund.

The overall pooling fund means that all unit contributions are put into a unified fund part of a public company, and then the funds are disbursed from this unified pooling fund to those insured persons who need to enjoy benefits.