Legal subjectivity: We all know that medical insurance is an important part of the social insurance system. The state has formulated relevant laws and regulations to clearly stipulate the obligation of employers to pay medical insurance for their employees.

Among them, the cost of personal medical insurance for employees is paid jointly by the unit and the individual employee.

1. Reimbursement ratio of employees’ personal medical insurance 1. For treatment in a first-level hospital, the minimum payment standard is 30,000 yuan. Basic medical insurance can pay 90% from the overall fund, and employees need to pay 10%.

If the fluctuation standard exceeds 30,000 to 40,000 yuan, the overall fund payment is as high as 95%, and individual employees only need to bear about 5%.

If the minimum payment standard exceeds 40,000 yuan, the overall fund payment of basic medical insurance is 97%, and the individual employee payment is 3%.

2. For medical treatment in a secondary hospital, the minimum payment standard is 30,000 yuan. The basic medical insurance can pay 87% from the overall fund, and the employee’s personal payment reaches 13%; if the medical expenses exceed 30,000 to 40,000 yuan,

92% can be paid by the overall fund, and individual employees need to pay 8%; if the medical expenses exceed 40,000 yuan, basic medical insurance can be paid by the overall fund, up to 97%, and individual employees only need to pay 3%.

3. For medical treatment in a tertiary hospital, the minimum payment standard reaches 30,000 yuan for medical expenses. Basic medical insurance can pay 85% from the overall fund, and individual employees only need to pay 15%; if the medical expenses exceed 30,000 to 40,000 yuan,

, 90% of basic medical insurance can be paid by the overall fund, and individual employees only need to pay 10%; if the medical expenses exceed 40,000 yuan, 95% can be paid by the overall fund, and individual employees only need to pay 5%.

4. Among them, the personal payment ratio of retirees only accounts for 60% of the employee payment ratio.

2. Prerequisites for reimbursement of employee personal medical insurance 1. The applicant has gone through the insurance enrollment procedures and paid the medical insurance premium in full.

2. If the insured person incurs hospitalization medical expenses while seeking medical treatment at a registered medical institution, he must pay cash in advance and keep relevant documents and information.

3. Seeking medical treatment at designated cooperative medical institutions: ordinary outpatient and emergency expenses incurred by insured persons in medical insurance designated hospitals or specialized hospitals, traditional Chinese medicine hospitals and Class A hospitals of personal choice.

4. Prepare original invoices: general outpatient and emergency medical expenses must be paid in personal cash. The resulting medical expenses must be within the scope of the three major catalogs of medical insurance.

5. Bring your medical insurance card and ID card: from the 1st to the 20th of each month, the expenses for the current month will be declared in the next month, and the expenses for the current year will be applied for reimbursement before January 20th of the following year.

6. The insured person submits the documents to the unit or social security office. The unit or social security office enters the documents into the enterprise version, and then reports the electronic information and documents to the medical insurance center.

Once an employee becomes ill, he or she needs medical insurance for reimbursement.

The reimbursement ratio of general medical insurance will vary depending on the level of medical care and the amount of medical expenses spent.

The above is the relevant content about the reimbursement ratio of employees’ personal medical insurance. I hope it will be helpful to everyone.

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