After participating in the social basic medical insurance, if they are on-the-job employees, they can be reimbursed for medical expenses exceeding 2,000 yuan after seeing a doctor in a hospital outpatient or emergency department, and the reimbursement ratio is 50%. For retirees under the age of 70, medical expenses above 1300 can be reimbursed, and the reimbursement rate is 70%.

No matter what kind of personnel, the maximum payment limit for outpatient or emergency medical expenses is 20 thousand yuan. For example, if you are an on-the-job employee and spend 2,300 yuan on outpatient service, 300 yuan can reimburse 50% of the excess, that is, 150 yuan.

If it is hospitalization expenses, the minimum payment will be 1300 when the social basic medical insurance is used for the first time within one year, regardless of whether the employee is working or retired. If the second and later hospitalization medical expenses are calculated at 50%, that is, 650 yuan. Within one year, the maximum payment for hospitalization expenses of basic medical insurance is currently 70,000 yuan.

Generally speaking, the reimbursement standard of hospitalization expenses is also related to the hospital level where the insured person is located. If you live in a tertiary hospital, the minimum payment is 30,000, and employees need to pay 15%, which means 85% reimbursement; Between 30,000 yuan and 40,000 yuan, employees need to pay 10% and reimburse 90%; If the expenses exceed 40,000 yuan to the maximum payment limit, employees only need to pay 5%, and 95% can be reimbursed. Retirees pay 60% of the employees. If you are below the threshold, you need to pay for it yourself.

Reimbursement scope:

Medical expenses: auxiliary examination: the examination expenses of electrocardiogram, X-ray fluoroscopy, radiography, laboratory test, physiotherapy, acupuncture, CT and MRI are limited to 200 yuan;

Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 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.

Reimbursement ratio: town health centers reimburse 60%; 40% reimbursement for secondary hospitals; Third-level hospitals are reimbursed 30%.

All inpatients who participate in cooperative medical care, whose medical expenses exceed 5,000 yuan at one time or for the whole year, should be compensated by stages, that is, 500 1- 10000 yuan is 65%, and1-18000 yuan is 70%.

The annual compensation limit of town-level cooperative medical system hospitalization, uremia outpatient hemodialysis and tumor outpatient radiotherapy and chemotherapy is 1. 1 ten thousand yuan.