Subjectivity of law:

1. Medical insurance for urban workers 1. On-the-job workers: The outpatient service is exempted from reporting for 2, yuan, that is, out of the medical expenses incurred by the outpatient service, the part exceeding 2, yuan will be reimbursed, and the reimbursement ratio is 5%; 2. Retired employees: The outpatient fee-free quota is 1,3 yuan, that is, out of the medical expenses incurred by outpatient service, only those exceeding 1,3 yuan will be reimbursed. For those under 7 years old, the reimbursement rate is 7%, while for those over 7 years old, the reimbursement rate is 8%. 3. Maximum amount: No matter what kind of people, the maximum amount of outpatient and emergency medical expenses is 2, yuan. 4. Special diseases: In a medical insurance year, the amount of outpatient exemption for special diseases is 4 yuan, and the proportion of reimbursement for medical expenses that meet the prescribed treatment scope is the same as that of ordinary hospitalization. Second, medical insurance for urban residents. 1. General outpatient service: In a medical insurance year, there is no deductible line for general outpatient service, and the medical expenses within the scope of outpatient co-ordination fund will be reimbursed at the rate of 6%. The annual maximum personal payment limit of the co-ordination fund is 4 yuan. 2. Special diseases: In a medical insurance year, the amount of outpatient exemption for special diseases is 4 yuan, and the proportion of reimbursement for medical expenses that meet the prescribed treatment scope is the same as that of ordinary hospitalization. Third, the new rural cooperative medical insurance. 1, the village clinic and village center clinic for reimbursement of 6%, each prescription drug fee limit in 1 yuan, hospital doctors temporary rehydration prescription drug fee limit in 5 yuan. 2, the town hospital reimbursement 4%, each check-up fee and operation fee limit 5 yuan, prescription drug fee limit 1 yuan. 3, the secondary hospital reimbursement of 3%, each time the examination fee and operation fee limit 5 yuan, prescription drug fee limit 2 yuan. 4, tertiary hospital reimbursement of 2%, each visit the examination fee and operation fee limit 5 yuan, prescription drug fee limit 2 yuan. 5. The invoice of traditional Chinese medicine shall be attached with the 1 yuan for each prescription. 6, township cooperative medical outpatient compensation limit of 5 yuan. 7. Special diseases: In a medical insurance year, the amount of outpatient exemption for special diseases is 4 yuan, and the proportion of reimbursement for medical expenses that meet the prescribed treatment scope is the same as that of ordinary hospitalization. Legal objectivity:

Article 28 of the Social Insurance Law of the People's Republic of China conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid from the basic medical insurance fund in accordance with state regulations. Article 29 of the Social Insurance Law of the People's Republic of China, 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, the medical institution and the pharmaceutical business unit. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places, so as to facilitate the insured to enjoy the basic medical insurance benefits.