1. There is no deductible for outpatient reimbursement for general outpatient services. All insured residents enjoy general outpatient treatment.

Within a medical insurance year, there is no deductible for general outpatient services. Medical expenses within the payment range of the outpatient overall fund are reimbursed at a rate of 60%. The maximum annual individual payment limit of the overall fund is 400 yuan.

2. Hospitalization reimbursement ratio: The longer the insured period is, the greater the reimbursement ratio will be. For every 5 years of continuous payment by insured residents, the hospitalization reimbursement ratio of the medical insurance fund will increase by 5 percentage points, and the total will not exceed 10 percentage points.

If you participate in the insurance for 10 consecutive years from 2007, the hospitalization reimbursement ratio in third-level, second-level, and first-level hospitals will reach 70%, 80%, and 90% respectively.

3. Secondary reimbursement ratio. After "secondary reimbursement", there may be "reimbursement". Among the medical expenses incurred by insured residents for a single hospitalization, the part that falls within the payment scope of the urban residents' basic medical insurance co-ordinating fund will be included in the basic medical insurance co-ordinating fund.

After proportional payment, if the personal burden exceeds 8,000 yuan, the excess portion will be "secondary reimbursed" at a rate of 55% from the critical illness insurance funds.

Medical expenses incurred by insured residents for multiple hospitalizations in an individual year. After payment of basic medical insurance and "secondary reimbursement", the accumulated annual hospitalization medical expenses (including compliant and reasonable self-pay portion) exceeds 25,000 yuan.

, the excess amount will be "reimbursed" at a rate of 55% by the critical illness insurance funds, and the annual maximum personal payment limit of the critical illness insurance funds is 250,000 yuan.

4. The reimbursement amount can be reimbursed up to 370,000 yuan per year. Residents participating in our city's urban resident medical insurance have an annual payment limit of 120,000 yuan for basic medical insurance and 250,000 yuan for critical illness insurance.

Therefore, insured persons can be reimbursed up to 370,000 yuan per year.

Extended information: 1. Medical insurance reimbursement materials 1. Original ID card or social security card.

2. Original disease diagnosis certificate issued by a specialist at a designated medical institution.

3. Original medical certificates such as outpatient medical records, examinations, test result reports, etc.

4. A detailed list of outpatient expenses printed from the hospital computer or the original prescription issued by the doctor.

5. The original unified invoice and computer printed list of tax merchandise sold in designated pharmacies.

6. If you apply on behalf of someone else, you need to provide the original ID card of the agent.

2. Reimbursement Process 1. Bring reimbursement materials to the relevant departments of the local social security center to apply. After review, if the information is complete and meets the conditions, it can be processed immediately.

2. When the applicant applies for outpatient medical expense reimbursement, the amount transferred to the medical insurance personal account in the current social security year will be deducted first, and then the reimbursement amount will be determined.