1. The maximum reimbursement rate for hospitalization for low-income households is 60%. For low-income households, five-guarantee elderly people, preferential pensioners and other needy people who are admitted to hospitals for treatment of illnesses, the remaining portion of the expenses after being reimbursed by the New Rural Cooperative Health Insurance (NRCCH) or the Urban Medical Insurance (UMIC) can be reimbursed by 65% again, with a ceiling of 35,000 yuan.
2. The medical expenses borne by the patient are the remaining expenses after two reimbursements plus the out-of-pocket expenses.
The conditions required for a low-income household are as follows:
1, those who do not have a legal provider, or those who have a legal provider but the provider is incapable of providing support;
2, those who are incapable of working;
3, those who do not have a source of livelihood (excluding garbage collectors, which are not explicitly stipulated in the law as having a source of livelihood);
4, elderly, disabled, villagers under the age of 16. Those who meet one of these conditions may apply for low income households. Determination of the low-income object should be applied for by the person himself or nominated by the villagers' committee. If the person is unable to express his will due to his young age or intellectual disability, the villagers' group or other villagers will apply on his behalf, and the villagers' committee will review and announce the application and report it to the township government for review, verification and approval.
To summarize, although the low income insurance can help some families to alleviate their living difficulties to a certain extent, if they rely on the low income insurance for a long time, it may have an adverse effect on the growth of their children. The government and the society should provide the low income insurance while focusing on the improvement of the family's self-development ability, and promote the family's self-development and poverty alleviation.
Legal basis:
Article 2 of the Social Insurance Law of the People's Republic of China
The state establishes a social insurance system for basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance and other social insurance, and guarantees the right of citizens to receive material help from the state and society in accordance with the law in the event of old age, sickness, industrial injury, unemployment and childbirth.
Article 28
Medical expenses that conform to the basic medical insurance drug list, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergencies and rescues, shall be paid out of the basic medical insurance fund in accordance with the provisions of the State.
Article 29
The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.