Proportion of reimbursement of medical insurance for employees in Xinxiang City

Legal analysis: if the medical expenses of insured residents in designated medical institutions meet the requirements, the reimbursement rate of first-class hospitals is 87%, that of second-class hospitals is 80%, and that of third-class hospitals is 75%. In addition, the maximum payment limit of the basic medical insurance fund in an insurance year is 654.38+10,000 yuan.

According to the regulations, the proportion of medical insurance reimbursement for residents hospitalized in medical institutions outside the city is 75%. In addition, the reimbursement rate for special diseases in the basic medical insurance for urban residents is 80%.

Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC), the following medical expenses are not included in the payment scope of the basic medical insurance fund:

(1) shall be paid by the industrial injury insurance fund (2) shall be borne by a third party (3) shall be borne by public medical care (4) overseas medical care.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.