Class B yao individuals bear 10%. If the insured uses Class B drugs that have been marked with a personal burden ratio, the individual will first pay according to the marked ratio, and the rest will be paid in accordance with the provisions of the Urban Employee Basic Medical Insurance; if the insured person uses a medicine that has not been marked with a personal burden ratio For Class B drugs, the individual must first pay 10% of the drug cost, and the remainder shall be paid in accordance with the provisions of the basic medical insurance for urban employees. Therefore, medical insurance Class B yao is not self-paying yao, but is partially self-paying, and the proportion is different for each drug. Class A drugs are uniformly formulated by the state. When insured people use Class A drugs, they can be fully included in the scope of reimbursement. Category B yao will be more effective than the same type of category A yao, but it is more expensive. There are 817 types of category B yao on the list
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< p>Unit medical insurance reimbursement ratio: According to the provisions of the "Implementation Plan", employees' basic medical insurance premiums are paid jointly by the employer and individual employees. Employers pay 7% of the total wages on file for their employees; employees pay 2% of their wages on file. Individual retirees do not need to pay basic medical insurance premiums, but the employer must pay them in accordance with relevant regulations. According to relevant regulations, all legal employers in cities and towns, including public institutions, enterprises, government agencies, social groups, private non-enterprise units and their employees, must participate in employee medical insurance in accordance with regulations.1. Employee medical insurance reimbursement ratio If the insured employee is still employed, the medical expenses incurred for hospitalization above the minimum payment standard and below the maximum payment limit shall be borne jointly by the medical insurance fund and the individual. The proportion of personal responsibility is 6% for first-level hospitals, 8% for second-level hospitals, and 10% for third-level hospitals; for retirees and active employees with more than 30 years of service, the personal share is halved. In a calendar year, the maximum payment limit of the medical insurance fund is 50,000 yuan; the maximum payment limit of the medical assistance fund is 170,000 yuan.
2. The reimbursement ratio of retired employees’ medical insurance. The medical expenses incurred by retired employees for medical treatment are above the deductible line and below the maximum payment limit. Inpatient medical expenses, Class A drugs and general diagnosis and treatment expenses are in line with the payment scope of basic medical insurance. The employee pooling fund pays 85%, the retirees pooling fund pays 90%; the Class B drug pooling fund pays 75%; the high-precision examination and treatment pooling fund pays 70%.
3. The use of employee medical insurance stipulates that the funds in the personal account of employee medical insurance shall not be used for other purposes and can only be used for personal medical and health expenses; the personal account of the insured person can also be used for purchases at designated retail pharmacies. Drugs and medical devices within the prescribed scope. In the future, insured persons can use their social security cards to purchase all drugs of approved brands and medical devices of medical device brands at designated retail pharmacies. To sum up, when insured employees are hospitalized, the proportion of personal liability is 6% for first-level hospitals, 8% for second-level hospitals, and 10% for third-level hospitals. In addition, 85% of Class A drugs and general diagnosis and treatment expenses will be paid by the pooled fund for active employees, and 90% will be paid by the pooled fund for retirees.