1, if it belongs to rural medical insurance, then town hospitals will reimburse 60%, secondary hospitals 40% and tertiary hospitals 30%;
2. If the party concerned belongs to urban medical insurance, the reimbursement rate of tertiary hospitals is 50%, and the upper limit is 2,000 yuan. The minimum payment standard for secondary hospitals is 55% in 300 yuan, the maximum payment for hospitalization is 654.38+10,000 yuan, and the hospitalization payment rate is 70%.
Legal basis: Article 29 of the Social Insurance Law of People's Republic of China (PRC).
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.
Article 30
The following medical expenses are not included in the payment scope of the basic medical insurance fund:
(a) shall be paid by the industrial injury insurance fund;
(2) It shall be borne by a third party;
(three) shall be borne by public health;
(4) Go abroad for medical treatment.
Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.
What are the conditions for medical insurance reimbursement?
1, cooperative medical system designated medical institutions for medical treatment;
2. Original invoice;
3. Medical insurance card and my ID card.