Retired employee medical insurance reimbursement ratio: retired employees with more than 30 years of service are reimbursed 90% of their medical and pharmaceutical costs; those with 21 to less than 30 years of service are reimbursed 85%; those with 15 to less than 21 years of service are reimbursed 80%; and those with less than 15 years of service are reimbursed 75% of their medical and pharmaceutical costs.
The reimbursement rate for retiree health insurance is different from place to place, around 85-95%.
Check your local health insurance policy. Hospitalization costs are reimbursed according to the level of hospital and hospitalization costs.
The reimbursement rate for tertiary hospitals is 1,300 to 30,000 yuan: 91 percent; 30,000 to 40,000 yuan: 94 percent; and more than 40,000 yuan: 97 percent.
The reimbursement rates for level II hospitals were 1,300 to $30,000: 92.2 percent; $30,000 to $40,000: 95.2 percent; and $40,000 or more: 98.2 percent.
The reimbursement rates for Level 1 hospitals were 1,300 to $30,000: 94 percent; $30,000 to $40,000: 97 percent; and more than $40,000: 98.2 percent.
The maximum payment limit is 70,000 yuan, and if it exceeds 70,000 yuan, the excess is reimbursed at 70 percent, regardless of hospital level.
Usually higher than for employed people, the reimbursement rate varies by hospital grade. Consult your local 12333 labor security hotline.
Legal basis
Article 30 of the Social Insurance Law
The following medical expenses are not included in the scope of payment by the basic medical insurance fund:
(a) Those that should be paid from the Workers' Injury Insurance Fund;
(b) Those that should be borne by a third person;
(c) Those that (ii) Should be borne by the public ****health;
(iv) Medical treatment outside the country.
Medical expenses shall be borne by a third person in accordance with the law, and if the third person fails to pay or if the third person cannot be identified, the basic medical insurance fund shall pay in advance.
The basic medical insurance fund shall have the right to recover the expenses from the third party after the first payment.