After using up, you will have to pay 1,500 yuan out-of-pocket. After the amount exceeds 1,500 yuan, there will be different reimbursement ratios according to the level of the hospital. It will be calculated directly when the hospital pays, and you only need to pay the out-of-pocket part.

If the accumulated self-pay amount is reached, reimbursement can be made according to the corresponding proportion. The specific proportion is: 1. The retiree shall bear 8% personally, and the medical insurance fund shall pay 86% and 92% respectively; 2. The individual shall bear 25% for outpatient treatment in a tertiary hospital, and the medical insurance shall pay 25%.

The fund pays 75%; 3. Employees who seek outpatient treatment in community hospitals bear 14% personally; 4. Individuals who seek outpatient treatment at other hospitals bear 20%, and the medical insurance fund pays 80%.

Employee medical insurance is generally divided into individual accounts and pooled accounts, among which: (1) The individual account can pay for the following expenses: 1. Drug purchases at designated retail pharmacies, outpatient and emergency medical expenses; 2. Used for personal purchase of commercial insurance and accident insurance

etc.; 3. Medical expenses below the basic medical insurance pooling fund threshold; 4. If the medical expenses exceed the basic medical insurance pooling fund threshold, the personal expenses payable shall be borne in proportion. 5. If the personal account is insufficient to pay, the person shall pay the part.

(2) The overall account mainly pays for the following expenses: 1. Medical expenses for hospitalization; 2. Outpatient medical expenses for anti-rejection drugs after radiotherapy for malignant tumors, renal dialysis, and kidney transplantation; 3. Hospitalization expenses after emergency rescue

The patient's medical expenses will be paid within seven days before hospitalization.

The legal basis is Article 27 of the "Social Insurance Law of the People's Republic of China". Individuals who participate in the basic medical insurance for employees, and when they reach the legal retirement age, their cumulative contributions reach the number of years specified by the state, they will no longer pay basic medical insurance premiums after retirement. According to

The state stipulates that you can enjoy basic medical insurance benefits; those who have not reached the number of years stipulated by the state can pay premiums up to the number of years stipulated by the state.

Article 28 Medical expenses that comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue expenses shall be paid from the basic medical insurance fund in accordance with national regulations.

Article 29 The portion of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit.

The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.