According to the Social Insurance Law of People's Republic of China (PRC) and related laws and regulations, the reimbursement rate of employee medical insurance is generally 80%, that is, 80% of medical expenses can be reimbursed by the social medical insurance fund, and the remaining 20% needs to be borne by individuals themselves. However, it should be noted that this ratio is for different medical projects, and different projects may have different reimbursement ratios, such as special diseases, serious diseases, outpatient services, etc. In addition, not all medical expenses can be enjoyed by employees, and the specific requirements also need to meet the relevant provisions of the medical insurance policy, such as hospitalization needs to be carried out in designated hospitals, outpatient treatment needs to be reimbursed in advance, and so on. The specific requirements vary from region to region, and the insured should pay more attention to the social security policies and regulations in the region. In a word, it is very important for the insured to know the proportion of medical insurance reimbursement for employees, which can help them to know their rights and interests in time, plan medical expenses reasonably and save personal medical expenses.
Can you increase the proportion of medical insurance reimbursement for employees by other means? In addition to the proportion of medical insurance reimbursement for employees, some areas have also implemented policies such as medical insurance pooling fund and commercial medical insurance, which can appropriately increase the proportion of reimbursement. However, the specific implementation rules of these policies vary from region to region, so it is necessary to check the relevant information of local social security policies and operate as required.
The proportion of medical insurance reimbursement for employees is one of the important indicators for the insured to enjoy social insurance benefits. Insured personnel should carefully understand social security policies and regulations, abide by relevant social security regulations, and at the same time improve their reimbursement ratio by understanding other medical insurance policies.
Legal basis:
Article 40 The sources of social insurance funds in the Social Insurance Law of People's Republic of China (PRC) include: (1) social insurance premiums paid by the insured and the employer in accordance with regulations; (2) National, local and relevant departments; (3) social donations; (4) Other lawful income.