1, 88% of the threshold fee is more than 3,000 yuan;

2, 3000-5000 yuan is 90%;

3, 5000- 10000 yuan is 92%;

4. 10000 yuan to 95% of the maximum payment limit, including 80% for Class B drugs, 70% for expensive drugs and 70% for special inspection and treatment.

Steps for reimbursement of medical insurance in different places:

1, discharge summary, invoice and medication list issued by different hospitals;

2. My ID card, medical insurance card and medical certificate issued by the unit. Non-enterprise insured, no need to issue a certificate of medical treatment in different places issued by the unit;

3. The transfer certificate issued by the local hospital needs to be issued by the attending physician, and then signed by the director of the department where the attending physician is located, and then go to the hospital medical insurance office to handle the transfer certificate;

4. The reimbursement for returning to the local area for medical treatment in different places is less than that in the local area 10%, and there is 20% less without the transfer certificate issued by the local hospital;

5. Take the above information to the local medical insurance office.

Medical insurance coverage:

1, drug reimbursement for basic medical insurance

Our country now divides drugs into three categories: A, B and C, among which A drugs are within the scope of medical insurance, so medical insurance can only reimburse A drugs, and B and C drugs cannot be reimbursed;

2. Reimbursement of basic medical service facilities

This reimbursement scope mainly refers to bed fees, first-aid bed fees, consulting fees, etc. Expenses incurred by the insured in the process of diagnosis, treatment and nursing in designated medical insurance institutions;

3, the basic medical insurance treatment project reimbursement

It must be a safe and effective diagnosis and treatment, and the charging standard shall be determined by the price department. Need to be treated in a designated medical institution.

To sum up, pooling funds and individual accounts should delimit their respective payment ranges, account for them separately, and shall not occupy each other. Determine the qifubiaozhun and the maximum payment limit of the overall fund. In principle, the qifubiaozhun is controlled at about 10% of the average annual salary of local employees, and the maximum payment limit is controlled at about 4 times of the average annual salary of local employees.

Legal basis:

Article 29 of People's Republic of China (PRC) Social Insurance Law

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.