The proportion of hospitalization reimbursement for urban medical insurance needs to be judged according to the following situations:

1. The proportion of reimbursement is different with different levels of hospitals, such as 6% reimbursement for hospitalization in town health centers;

2. For the first-class hospitals, 9% shall be paid for the part above the Qifubiaozhun to the highest payment limit;

3. For secondary hospitals, 85% will be paid for the part with the minimum threshold of 1, yuan (inclusive), and 9% will be paid for the part above 1, yuan to the maximum payment limit;

4. For tertiary hospitals, 8% will be paid for the part with the minimum threshold of 5, yuan (inclusive), 85% for the part with the minimum threshold of 5, yuan to 1, yuan, and 9% for the part with the maximum payment limit of 1, yuan or more;

5. The auxiliary examination mainly includes the examination fees for ECG, X-ray fluoroscopy, radiography, laboratory tests, physiotherapy, acupuncture, CT and nuclear magnetic resonance imaging, etc. 2 yuan;

6. Operation expenses (referring to national standards, those exceeding 1 yuan will be reimbursed by 1 yuan), and the elderly over 6 years old will be hospitalized in health centers, and the treatment expenses and nursing expenses will be compensated to 1 yuan every day, with a limit of 2 yuan;

7. Retirees will be increased by 5% on the basis of the above payment ratio.

legal basis

article 26 of the social insurance law of the people's Republic of China, 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 27 (1) Individuals who participate in the basic medical insurance for employees, if the accumulated payment reaches the number of years stipulated by the state when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state;

(2) if the fixed number of years stipulated by the state has not been reached, the payment can be made to the fixed number of years stipulated by the state. Twenty-ninth (a) 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 institutions and pharmaceutical trading units;

(2) The social insurance administrative department and the health administrative department shall establish a settlement system for medical expenses in different places, so as to facilitate the insured to enjoy the basic medical insurance benefits.