The reimbursement rate of medical insurance is: for senior citizens over 70 years old, other urban residents, students and children, if they have incurred medical expenses of less than 100,000 yuan (students and children: 180,000 yuan) which are eligible for reimbursement, the starting standard for third-level hospitals is 500 yuan, and the reimbursement rate is 50% (students and children: 55%); the starting standard for second-level hospitals is 300 yuan, and the reimbursement rate is 60%; and the reimbursement rate for first-level hospitals is 65%.
Legal Basis
Article 28 of the Social Insurance Law
Medical expenses that are in line with the basic medical insurance drug list, diagnostic and treatment items, standards of medical service facilities, as well as those for emergencies and salvages, shall be paid out of the basic medical insurance fund in accordance with state regulations.
Article 29
The portion of the medical expenses of the insured 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.