1. The reimbursement ratio varies from place to place, and the specific payment ratio of basic medical insurance is adjusted in time according to the principles of adapting the basic medical insurance level to the local economic and social development level, maintaining a reasonable gradient of basic medical insurance benefits and improving the efficiency of medical resources use. Taking Shanghai as an example, if the medical expenses incurred by retirees in hospitalization or emergency observation room within one year exceed the minimum deductible, 92% will be paid by the overall fund;

2, the basic medical insurance payment ratio, outpatient and emergency expenses standard, pooling fund Qifubiaozhun, pooling fund and additional fund payment ratio, pooling fund maximum payment limit, should be adjusted according to the basic medical insurance level and the city's economic and social development level, maintain a reasonable gradient of basic medical insurance benefits, and improve the efficiency of medical resources. The specific adjustment plan shall be studied and demonstrated by the Municipal Human Resources and Social Security Bureau in conjunction with relevant departments, and shall be promulgated and implemented after being approved by the Municipal People's Government;

As we all know, the elderly are particularly prone to illness when they are old. Once you get sick, you have to be hospitalized. For poor families, it can be said that having medical insurance can greatly alleviate people's economic pressure. However, understanding the reimbursement of hospitalization medical insurance is related to our personal policy. At present, according to Bian Xiao, the reimbursement rate for the elderly under 70 is 85%. 70 years old and above to 89 years old, the reimbursement rate is 100%. In addition, more than 70% of the elderly over 65 are reimbursed for hospitalization;

4. Reimbursement ratio of hospitalization expenses in rural areas: 60% in town hospitals; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%. Note: If the operation cost exceeds 1 1,000 yuan, it will be reimbursed 1 1,000 yuan; The elderly over 60 years old are hospitalized in health centers, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.

The reimbursement process is as follows:

1. The reimburser applies for reimbursement and fills in the expense reimbursement form;

2. The head of the reimbursement department or the superior supervisor confirms the signature;

3. The financial supervisor should review the reimbursement form and documents;

4, the company general manager for approval;

5. The cashier checks and executes the payment.

To sum up, the reimbursement rate of the elderly over 80 years old in designated medical institutions at or above the county level in the province is 80%, and the reimbursement rate of the elderly over 90 years old is 90% (for the poor population, the reimbursement rate is implemented according to the principle of "high is not low, township hospitals do not exceed 95%, and the highest at or above the county level does not exceed 90%").

Legal basis:

Article 23 of People's Republic of China (PRC) Social Insurance Law

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Article 28

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

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.