The proportion of medical insurance hospitalization reimbursement for employees in Wuhan, the expenses above the basic medical insurance Qifubiaozhun and within the annual payment limit (240,000) are divided into different proportions according to the hospital level and expenses, and paid by the medical insurance fund according to different proportions.

The annual cumulative cost of basic medical insurance is less than 654.38 million, and the proportion of medical insurance fund is as follows:

1.92% (on-the-job) and 93.6% (retired) are paid by community and first-class hospital funds;

2. The secondary hospital fund pays 89% (on-the-job) 9 1.2 (retirement);

3.86% (in-service) and 88.8% (retired) are paid by the tertiary hospital fund;

4 persons with disabilities who enjoy subsistence allowances shall be paid by the overall fund at 2%.

(2) The annual cumulative cost of basic medical insurance is10-200,000, and the medical insurance fund pays 94%.

(3) The annual cumulative cost of basic medical insurance is 200,000-240,000, and the medical insurance fund pays 98%.

(4) The individual pays 10% for the use of Class B drugs or medical treatment items covered by medical insurance, and the balance is paid by the medical insurance fund according to the above proportion.

Proportion of reimbursement for serious illness in outpatient department:

Insured employees with social security cards who treat severe (chronic) diseases in designated hospitals meet the medical expenses paid by the medical insurance fund for employees. The outpatient co-ordination fund for severe (on-the-job) diseases pays 80% (on-the-job) and 85% (retired), and the outpatient co-ordination fund for chronic diseases pays 60% (on-the-job) and 65% (retired). Some serious outpatient diseases (malignant tumor, renal dialysis, anti-rejection therapy after renal transplantation and anti-rejection therapy after liver transplantation) are paid by the fund for 87% (in-service) and 90% (retired). For the use of Class B drugs or medical treatment items within the scope of medical insurance, the individual pays 10% first, and the balance is paid by the medical insurance fund according to the above proportion.

Legal basis:

Article 26 of the Social Insurance Law of People's Republic of China (PRC): The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Article 28 of People's Republic of China (PRC) Social Insurance Law: Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29 of the Social Insurance Law of People's Republic of China (PRC): 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 institution and 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 to facilitate the insured to enjoy the basic medical insurance benefits.