Legal subjectivity:

Proportion of medical insurance reimbursement: 1. There is no deductible line for outpatient reimbursement. All insured residents enjoy the treatment of general outpatient service. In a medical insurance year, there is no deductible line for general outpatient service, and the medical expenses within the scope of outpatient co-ordination fund payment are reimbursed according to the proportion of 6%, and the annual maximum personal payment limit of co-ordination fund is 4 yuan. 2. The proportion of hospitalization reimbursement The longer the continuous insured time, the greater the reimbursement proportion. For every five years of continuous payment by insured residents, the proportion of hospitalization reimbursement of medical insurance fund will increase by 5 percentage points, and the cumulative amount will not exceed 1 percentage points. If you have been insured for 1 consecutive years since 27, the hospitalization reimbursement rates in tertiary, secondary and primary hospitals will reach 7%, 8% and 9% respectively. Legal objectivity:

Reimbursement ratio of medical insurance for urban residents in Shanxi Province 1. Reimbursement ratio of urban residents: first-class hospital: 85. Second-class hospital: 7. Third-class hospital: 6. Emergency hospitalization: 5. Referral to foreign third-class hospital: 55. General outpatient service. Reimbursement ratio: 5% of medical expenses above Qifubiaozhun that meet the overall payment scope of outpatient service. 2. The reimbursement rate for urban workers: 15% for first-class hospitals, 17% for second-class hospitals and 19% for third-class hospitals within 5, yuan (including 5, yuan); Within 5, yuan to 15, yuan (including 15, yuan), individuals pay 13% for first-class hospitals, 15% for second-class hospitals and 17% for third-class hospitals; Individuals with more than 15, yuan pay for 11% of first-class hospitals, 13% of second-class hospitals and 15% of third-class hospitals. Medical insurance refers to social medical insurance, which is a social insurance system established to provide basic medical needs protection for workers within the scope of protection. The basic medical insurance premiums paid by individual employees are all included in individual accounts; The basic medical insurance premium paid by the employer is divided into two parts, one part is included in the personal account and the other part is used to establish the overall fund. Legal basis: Article 29 of the Social Insurance Law of the People's Republic of China, 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. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places, so as to facilitate the insured to enjoy the basic medical insurance benefits. Article 3 of the Social Insurance Law of the People's Republic of China The following medical expenses are not included in the payment scope of the basic medical insurance fund: (1) Those that should be paid from the industrial injury insurance fund; (2) It shall be borne by a third party; (three) shall be borne by the public health; (4) seeking medical treatment abroad. Medical expenses shall be borne by the third party according to law. If the third party fails to pay or cannot determine the third party, the basic medical insurance fund shall pay in advance. After the basic medical insurance fund has paid in advance, it has the right to recover from the third party.