Legal subjectivity:

Medical insurance for medical treatment in different places can also be reimbursed, but the reimbursement rate of medical insurance for medical treatment in different places will be less than that in local areas.

1. How much is the reimbursement rate of medical insurance in different places

1. Medical expenses for outpatient and emergency treatment: the part of medical expenses that meet the scope of basic medical insurance for employees in the year (from January 1 to December 31) has accumulated more than 2, yuan.

2. Settlement ratio: 5% of the part of the dispatched personnel over 2, yuan will be reimbursed during the contract period, and 5% will be paid by the individual; In a year, the maximum amount of accumulated reimbursement for dispatched personnel for outpatient and emergency services is 2, yuan.

3. Insured personnel should properly keep the outpatient medical documents (including receipts and prescriptions below a large amount) that are treated in designated hospitals as medical expense reimbursement vouchers.

4. Outpatient medical treatment for three kinds of special diseases: When the insured person needs to take anti-rejection drugs after radiotherapy and chemotherapy for malignant tumor, renal dialysis and renal transplantation, the second-and third-level designated hospitals where the insured person goes to see a doctor will issue a "disease diagnosis certificate", fill in the "Declaration and Approval Form for Special Diseases of Medical Insurance" and report it to the district medical insurance center for approval and filing.

Outpatient treatment and drug collection for these three special diseases are limited to the designated hospitals approved for treatment, and cannot be purchased at designated retail pharmacies. If the medical expenses incurred meet the prescribed scope of outpatient special diseases, they shall be settled with reference to hospitalization.

5. Hospitalization. Only after paying medical insurance for 2 years can you enjoy medical insurance reimbursement after retirement.

second, how much should employees pay for medical insurance every year

generally speaking, in terms of medical insurance payment for employees, men pay for 25 years and women pay for 2 years. In this case, after retirement, you can also enjoy medical reimbursement benefits. As for the payment standard, in fact, the annual payment amount is uncertain, depending on your salary base and payment grade. So, there is no definite amount.

Employees' social security establishes personal accounts, which are mainly used for seeking medical treatment in outpatient clinics of designated medical institutions and purchasing medicines in designated retail pharmacies. There is no personal account for residents' medical insurance, and outpatient medical treatment is coordinated. As the medical insurance certificate of the insured, there is no money in the medical insurance card, but the detailed information of the insured and the payment and reimbursement are recorded. It is suggested to consult the local social security bureau.

as for the amount of money returned, it is actually not fixed. Every employee's medical insurance payment standard is different, so the money returned is different. Also, generally speaking, only employees' medical insurance can return money, and individuals can't return money if they pay medical insurance. Because individuals pay social security at their own expense, there is no part of enterprise payment, so there is no money back before retirement, and only after retirement can money be returned to the card.

Third, the scope that medical insurance cannot be reimbursed

1. Not seeing a doctor in a designated hospital

Medical insurance cards can only be used in designated hospitals, and medical insurance will be reimbursed. Medical insurance will not be reimbursed if you fail to see a doctor in a designated medical institution. And the higher the level of hospital treatment, the lower the proportion of reimbursement.

2. Exceeding the reimbursement limit

After the unified medical insurance for urban and rural residents, the real-time reimbursement of medical expenses has been realized, and the reimbursement ratio is still the same as before, but the accumulated amount of reimbursement in one year is limited.

3. Special medical treatment

(1) Medical expenses for traffic accidents or work-related injuries due to personal reasons will not be reimbursed.

(2) Medical expenses caused by drunk driving, drug abuse, theft and other reasons will not be reimbursed by medical insurance.

(3) Medical expenses caused by abortion, abortion and other reasons due to personal reasons will not be reimbursed by medical insurance.

(4) Medical expenses caused by plastic surgery, beauty treatment and weight loss will not be reimbursed by medical insurance.

4. Specialized treatment

Some medical projects will have special medical project funds, such as children's vaccination, and some related institutions will vaccinate children for free. If parents take their children for vaccination at their own expense, it is not within the scope of medical insurance reimbursement, so medical insurance will not be reimbursed.

although the scope of medical insurance reimbursement is getting wider and wider, there are still cases where medical insurance will not be reimbursed. Therefore, everyone must understand the scope of medical insurance reimbursement and avoid unnecessary troubles when reimbursement.

according to the law, it can be known that the proportion of medical insurance reimbursement is related to many factors, and the reimbursement of different identities is also different, which is determined according to the actual situation. Legal objectivity:

Article 28 of the Social Insurance Law

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

article 29

the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, medical institutions and pharmaceutical trading units.

the social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in different places, so as to facilitate the insured to enjoy the basic medical insurance benefits.