Legal analysis: 50 yuan for community health service centers (or first-level medical institutions), 100 yuan for second-level medical institutions, and 300 yuan for third-level medical institutions.
For medical expenses exceeding the minimum payment standard, the payment ratio of the Urban Resident Medical Insurance Fund will be adjusted as follows. The remaining medical expenses will be borne by the insured: For those over 70 years old, the fund payment ratio will be adjusted from 70% to: at the community health service center (
If you seek medical treatment at a first-level medical institution or a first-level medical institution), you will pay 85%; if you seek medical treatment at a second-level medical institution, you will pay 75%; if you seek medical treatment at a third-level medical institution, you will pay 65%.
For persons over 60 years old but under 70 years old, the fund payment ratio is adjusted from 60% to: 85% for those who seek medical treatment at community health service centers (or first-level medical institutions); 75% for those who seek medical treatment at second-level medical institutions;
For medical treatment in tertiary medical institutions, 65% will be paid.
For persons over 18 years old and under 60 years old, as well as primary and secondary school students and infants, the fund payment ratio is adjusted from 50% to: 75% for those who seek medical treatment at community health service centers (or first-level medical institutions); for those who seek medical treatment at second-level medical institutions
, pay 65%; those who seek medical treatment in tertiary medical institutions, pay 55%.
Through the above adjustments, the overall reimbursement ratio of hospitalization medical expenses under the city's urban residents' medical insurance has increased from about 61% to about 70%.
Legal basis: "Social Insurance Law of the People's Republic of China" Article 23 Employees shall participate in employee basic medical insurance, and the employer and employees shall jointly pay the basic medical insurance premiums in accordance with national regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other people with flexible employment can participate in the basic medical insurance for employees, and individuals must pay the basic medical insurance premiums in accordance with national regulations.