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Shanghai medical insurance hospitalization reimbursement ratio 202 1
The reimbursement of medical insurance for urban workers in Shanghai varies from 50% to 75% according to the age of patients and the level of hospitals. Generally, employees under the age of 44 exceed the deductible line for outpatient and emergency treatment 1.500 yuan. Employees who see a doctor in a first-class hospital can be reimbursed by medical insurance for 65%, and employees who see a doctor in a second-class hospital can be reimbursed by medical insurance for 60%. The medical insurance for employees in tertiary hospitals can be reimbursed by 50%.

On-the-job workers' outpatient and emergency treatment and hospitalization.

1. On-the-job staff outpatient service and emergency treatment

■ It is necessary to use up the amount included in the medical insurance in the current year before entering the self-financing section, with the self-financing amount 1.500 yuan.

■ When our own expenses exceed 65,438 yuan +0 500 yuan, we will reimburse them according to the following ratio.

2. Hospitalization or emergency observation room for observation and treatment.

■ If you need to be hospitalized, don't worry, as long as you pay medical insurance, most of the medical expenses can be borne by medical insurance.

■ First, we need to pay the deductible fee of 1500 yuan.

■ Expenses exceeding the deductible can be paid by medical insurance in proportion.

From July 1 day, the maximum payment limit of the employee medical insurance pooling fund will be raised from 530,000 yuan to 550,000 yuan, and the part exceeding the maximum payment limit will continue to be reimbursed 80% according to the regulations.

Outpatient, emergency and hospitalization of retired workers

1. Outpatient and emergency treatment

■ As long as you pay 15 employee medical insurance before retirement, you can enjoy medical insurance for life after retirement, and individuals don't have to pay.

■ Retired employees are older and may go to the hospital more often than before. Fortunately, the state is considerate, the conceit standard is lower than that of on-the-job employees, and the reimbursement ratio is higher than that of on-the-job employees.

2. Hospitalization or emergency observation room for observation and treatment.

Retirees who are hospitalized beyond the deductible only need to pay 8%, and most of them are paid by the medical insurance fund.