What are the medical expenses covered by medical insurance?

Medical insurance is a kind of insurance to compensate for medical expenses caused by illness. When an employee is sick, injured, or gives birth, the society or enterprise provides necessary medical services or material help. Such as China's public medical care and labor insurance medical care. The medical expenses of Chinese workers are borne by the state, the organization and the individual **** together, in order to reduce the burden on enterprises and avoid waste. The scope of medical insurance is very wide, and medical expenses are generally differentiated according to the characteristics of their medical services, which mainly include doctors' outpatient expenses, medicine, hospitalization, nursing care, hospital miscellaneous expenses, surgical expenses, and various examination expenses. Medical expenses are the costs incurred by the patient for treatment, which include not only the doctor's medical and surgical fees, but also the costs of hospitalization, nursing care, and hospital equipment. The reimbursement ratio and scope of medical insurance: 1. Outpatient and emergency medical expenses: the accumulated medical expenses over 2,000 RMB in the annual period (January 1~December 31) of an active employee that are in line with the scope of the basic medical insurance. 2. Settlement ratio: 50% reimbursement for the part of over 2,000 RMB for dispatched staff during the contract period, and 50% out-of-pocket payment by individuals; the maximum amount of outpatient and emergency reimbursement paid to dispatched staff is 20,000 RMB in a year. 3. The insured personnel should keep the outpatient medical receipts (including receipts and prescriptions for the part below the large amount) of the outpatient consultation at the designated hospitals as the proof of reimbursement of the medical expenses. 4、Outpatient medical treatment for three kinds of special diseases: when a participant needs outpatient medical treatment for radiation therapy and chemotherapy for malignant tumors, renal dialysis, or anti-rejection medication after renal transplantation, the second- and third-level designated hospitals where the participant seeks medical treatment will issue a "diagnosis certificate of disease" and fill in the "Declaration and Approval Form of Special Diseases for Medical Insurance", and then report it to the District Medical Insurance Center for approval and filing. For the record. Outpatient medical treatment and medication collection for these three special diseases are limited to the approved designated hospitals, and cannot be purchased at designated retail pharmacies. If the medical fees incurred are within the scope of outpatient special diseases, they will be settled with reference to hospitalization. 5. For inpatient medical treatment, medical insurance payment is sufficient for 20 years in order to enjoy the medical insurance reimbursement after retirement. Rural Cooperative Medical Insurance Reimbursement Ratio and Scope: 1. Outpatient Reimbursement: (1) 60% reimbursement for visits to village health centers and village central health centers, with a limit of 10 yuan for prescription drugs per visit and 50 yuan for temporary rehydration prescription drugs by the health center doctor. (2) 40% reimbursement for visits to township health centers, with a limit of RMB 50 per visit for various examinations and surgical procedures, and a limit of RMB 100 for prescription drugs. (3) 30% reimbursement for secondary hospitals, with a limit of RMB 50 for each examination and operation and RMB 200 for prescription drugs. (4) 20% reimbursement for tertiary hospital visits, with a limit of RMB 50 for each examination and operation and RMB 200 for prescription drugs per visit. (5) Chinese medicine invoice with prescription attached is limited to $1 per sticker. (6) Township-level cooperative medical outpatient compensation is limited to 5,000 yuan per year. 2、Hospitalization compensation (1) Reimbursement scope: A. Medicine: auxiliary examination: limit of 200 yuan for each examination fee such as EKG, X-ray fluoroscopy, radiography, laboratory test, physiotherapy, acupuncture, CT, nuclear magnetic **** vibration; surgery fee (with reference to the national standard, reimbursement will be made in accordance with the amount of 1,000 yuan for the examination fee in excess of 1,000 yuan). B. For elderly people over 60 years old who are hospitalized in Xingta Township Health Center, the treatment fee and nursing fee are compensated 10 yuan per day with a limit of 200 yuan. (2) Reimbursement ratio: town health center reimbursement 60%; secondary hospital reimbursement 40%. (3)Reimbursement of major illnesses town risk fund compensation: all participating in the cooperative medical treatment of hospitalized patients with a one-time or annual cumulative reportable medical expenses exceeding 5,000 yuan or more segmented compensation, i.e., 5,001-10,000 yuan compensation of 65%, 10,001-18,000 yuan compensation of 70%.