The reimbursement ratio is as follows: 1. For first-level hospitals, 90% of the portion from the minimum payment standard to the maximum payment limit is paid; 2. For second-level hospitals, 85% of the portion from the minimum payment standard to 10,000 yuan (inclusive) is paid, and above 10,000 yuan

The portion up to the maximum payment limit is paid at 90%; 3. For tertiary hospitals, the portion from the minimum payment standard to 5,000 yuan (inclusive) is paid at 80%, the portion from 5,000 yuan to 10,000 yuan (inclusive) is paid at 85%, and the portion from 5,000 yuan to 10,000 yuan (inclusive) is paid at 85%.

The portion above to the maximum payment limit is paid at 90%.

4. Retirees will receive an additional 5% increase on the above payment ratio.

Within a medical year, the overall fund’s payment for inpatient medical expenses and outpatient medical expenses for chronic diseases cannot exceed the maximum payment limit.

The maximum payment limit of the overall fund is 250,000 yuan.

According to the salary level of employees and the income and expenditure status of the overall fund, the minimum payment standard and maximum payment limit of the overall fund shall be adjusted in a timely manner by the municipal human resources and social security administrative department.

Medical insurance is a type of insurance that compensates for medical expenses caused by illness.

Social insurance that provides necessary medical services or material assistance to employees due to illness, injury, or childbirth, provided by the society or the enterprise.

Such as China's publicly funded medical care and labor insurance medical care.

Legal basis: Article 28 of the "Social Insurance Law of the People's Republic of China" that meets the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue medical expenses shall be deducted from the basic medical insurance fund in accordance with national regulations.

Pay.

Article 29 The portion of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit.

The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.

Article 30 The following medical expenses are not included in the payment scope of the basic medical insurance fund: (1) Those that should be paid from the work-related injury insurance fund; (2) Those that should be borne by a third party; (3) Those that should be borne by the public health department

; (4) Seeking medical treatment abroad.

Medical expenses should be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first.

After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party.