1, residents' medical insurance:

In an insurance year, if the general outpatient expenses of insured residents in designated outpatient medical institutions are within 100 yuan (inclusive), the residents' medical insurance fund will pay 30% and individuals will pay 70%; Personal consumption exceeds 100 yuan.

2, medical insurance for urban workers:

The personal account on the medical insurance card of the insured person insured by the unit is not paid by himself; The medical insurance card for flexible employees also has a personal account of 15 yuan every month since last year, which can be used to pay outpatient expenses, which is equivalent to outpatient reimbursement (unless the insured belongs to civil servants or the unit has other reimbursement policies). Medical insurance hospitalization, show the medical insurance card, read the card into the medical insurance system, pay the deposit (usually the threshold fee), and enter the fee into the system. The system automatically classifies it as self-funded, Class A, Class B, etc. Class B should be paid 10% first, and then enter the basic medical care. According to the annual number of inpatients (more than 1 threshold fee halved), hospital level (different threshold fees, overall planning,

Legal basis:

People's Republic of China (PRC) social insurance law

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, 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.