If you are purchasing social health insurance, then the reimbursement rates for different statuses are as follows:1. Students and children: In a settlement year, medical expenses under 180,000 yuan that are eligible for reimbursement, the starting standard for tertiary hospitals is 650 yuan, with a reimbursement rate of 50% and an upper limit of 2,000 yuan; for secondary hospitals, the starting standard is 300 yuan, with a reimbursement rate of 60%; and for primary hospitals, there is no starting standard, with a reimbursement rate of 65%. There is no starting standard and the reimbursement rate is 65%. 2. 70 years old and above: for medical expenses under 100,000 RMB within one billing year that are eligible for reimbursement, the starting standard for Level 3 hospitals is 650 RMB, the reimbursement rate is 50%, and the upper limit is 2,000 RMB; the starting standard for Level 2 hospitals is 300 RMB, and the reimbursement rate is 60%; Level 1 hospitals do not have a starting standard, and the reimbursement rate is 65%. 3、If the patient is insured under the New Rural Cooperative Medical Scheme (NRMS), the hospitalized patient's one-time or yearly accumulative reportable medical expenses exceeding RMB 5,000 yuan will be compensated in segments, i.e., RMB 5,001-10,000 yuan will be reimbursed at a rate of 65%, and RMB 10,001-18,000 yuan at a rate of 70%. Township-level cooperative medical care inpatient and uremia outpatient blood dialysis, oncology outpatient radiotherapy and chemotherapy reimbursement annual limit of 11,000 yuan.
Legal basis
The Chinese People's **** and the State Social Insurance Law, the twenty-eighth lead talk or article In line with the basic medical insurance drug catalog, diagnostic and treatment items, standards of medical services and facilities, as well as emergency, salvage medical expenses, in accordance with state regulations from the basic medical insurance fund. Article 29 of the Social Insurance Law of the People's Republic of China 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 locomotive medical institutions and pharmaceutical business units. The social insurance administrative department and the health administrative department shall establish a settlement system of medical expenses for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance treatment by the insured.
Legal basis
"The Chinese people*** and the whole of the State Social Insurance Law" Article 28 conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards, as well as emergency, rescue medical expenses, in accordance with state regulations from the basic medical insurance fund.
Article 29 of the Full Text of the Social Insurance Law of the People's Republic of China
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.