What is the reimbursement rate of ICU for employee medical insurance?

The reimbursement rate for ICU under the employee health insurance varies from region to region. Normally, the integrated fund of the first class designated medical institutions pays 60%, and the individual's out-of-pocket payment is 40%; the integrated fund of the second class designated medical institutions pays 55%, and the individual's out-of-pocket payment is 45%; and the integrated fund of the third class designated medical institutions pays 50%, and the individual's out-of-pocket payment is 50%. These ratios are general guidelines, and actual reimbursement rates may vary, so you need to consult your local Human Resources and Social Security Bureau for specific reimbursement information.

Types of medical insurance and coverage:

1. Basic medical insurance for urban workers: covering active workers and retirees of urban enterprises and institutions;

2. Basic medical insurance for urban residents: for urban residents who have not participated in the worker's medical insurance program, including minors, students, and the elderly;

3. New rural cooperative medical care ( New Rural Cooperative Medical Care (XRCMC): for rural residents, aiming to reduce the risk of rural residents being impoverished due to illness;

4. Major Disease Insurance: providing supplemental protection for insured people against high medical expenses, reducing the possibility of poverty or returning to poverty due to illness;

5. Medical Aid: mainly targeting low-income families and people in special hardship to provide assistance with medical expenses.

In summary, the reimbursement rate of employee health insurance in ICU varies from region to region, and the specific rate needs to consult the local human resources and social security bureau.

Legal basis:

The People's Republic of China*** and the State Social Insurance Law

Article 28

Medical expenses in line with the basic medical insurance drug catalog, diagnostic and therapeutic items, medical service facility standards, as well as emergency and rescue, shall be paid from the basic medical insurance fund in accordance with the state regulations

Article 29

The part 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.