Legal analysis: 1, scope of reimbursement: It is understood that after hospitalization, physical therapy fees, surgery fees, examination fees (ECG, X-ray, CT, nuclear magnetic resonance) and laboratory fees are included. If the patient is over 60 years old, the state will subsidize the hospitalization expenses per day 10 yuan, and the maximum subsidy will be to 200 yuan.

2, reimbursement ratio (1) outpatient compensation:

(1. 1) Village clinics and village center clinics are reimbursed 60%, and the prescription drug fee limit for each visit 10 yuan, and the prescription drug fee limit for temporary fluid replacement by doctors in health centers is 50 yuan.

(1.2) The town health center will reimburse 40%, and the examination fee and operation fee for each visit are limited to 50 yuan, and the prescription fee is limited to 100 yuan.

(1.3) 30% reimbursement for medical treatment in secondary hospitals. The limit of each examination and operation fee is in 50 yuan, and the limit of prescription fee is in 200 yuan.

(1.4) tertiary hospitals are reimbursed 20% for medical treatment. The limit of each examination and operation fee is in 50 yuan, and the limit of prescription drug fee is in 200 yuan.

(1.5) Prescription limit attached to traditional Chinese medicine invoice 1 yuan.

(1.6) The annual compensation limit for rural cooperative medical clinics is 5,000 yuan.

(2) hospitalization reimbursement standard

(2. 1) Reimbursement scope:

A medical expenses: auxiliary examination: the examination expenses of electrocardiogram, X-ray fluoroscopy, radiography, laboratory tests, physiotherapy, acupuncture, CT and nuclear magnetic resonance are limited to 200 yuan; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan).

B the elderly over B.60 years old are hospitalized in Xingta Town Health Center, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.

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

(3) Compensation for serious illness

Compensation from town risk fund: if the medical expenses of inpatients participating in cooperative medical care exceed 5,000 yuan at one time or for the whole year, they should be compensated by stages, that is, 5001-kloc-0/0000 yuan is 65%, and10001-8000 yuan is 75%. 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.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.

Article 3 The social insurance system adheres to the principles of wide coverage, basic protection, multi-level and sustainability, and the level of social insurance should be compatible with the level of economic and social development.