Reimbursement scope of serious illness medical insurance: when medical expenses exceed the maximum payment limit of the basic medical pooling fund, the social insurance department will reimburse 85% for the expenses below RMB -4,, 9% for the expenses below RMB 4,-8, and 95% for the expenses above RMB 8,. In each medical year, the maximum payment limit is RMB 15,.

according to the relevant regulations, all local enterprises (hereinafter referred to as enterprises) and their employees and retirees who are applicable to cities, districts and counties within the administrative area of this municipality can enjoy serious illness medical insurance. Retirees who do not pay the basic medical insurance premium and continue to enjoy the basic medical insurance benefits are not in the "serious illness medical insurance coverage".

serious illness medical care can be divided into two types in terms of insurance forms. One is social insurance for serious illness, which is a special medical insurance fund established to ensure the medical needs of urban workers for major diseases. It is used to pay the medical expenses accumulated by the insured who participate in the basic medical insurance for urban workers during the year that exceed the maximum payment limit of basic medical insurance. The other is the medical treatment of serious illness in commercial insurance, which is the major illness protection that the insurance company underwrites for a specific insurer according to the insurance clauses.

Further reading: How to buy insurance, which is better, and teach you how to avoid these "pits" of insurance.