Employee medical insurance is a social security system that aims to provide medical protection for insured employees and reduce the medical burden. Its function can reduce the burden of medical expenses on insured employees, especially in the face of major diseases or high medical expenses, medical insurance can provide certain financial support. Medical insurance can reimburse a portion of medical expenses, and individuals only need to pay the rest, thus reducing the financial pressure on individuals.
The reimbursement rate of employee medical insurance varies according to the level of hospitalization expenses, the level of the hospital, and the age and status of the personnel. Here are some common reimbursement ratios:
1. For in-service employees, after going to the outpatient and emergency department of the hospital, the medical expenses of more than 1,800 yuan can be reimbursed, and the reimbursement ratio is: 90% in community hospitals, 70% in other designated hospitals, and the maximum limit can be reported as 20,000 yuan.
2. For retirees under the age of 70, expenses of more than 1,300 yuan can be reimbursed, and the reimbursement ratio is: 85% (% of non-community hospitals).
3. For retirees over the age of 70, 90% of the hospital for more than 1,300 yuan can be reimbursed.
4. The reimbursement ratio for hospitalization is as follows:
1. If the hospitalization cost of employees is between 1,300 yuan and 30,000 yuan, the reimbursement ratio is 85%;
2. If the hospitalization cost of employees is between 30,000 yuan and 40,000 yuan, the reimbursement ratio is 90%;
3. If the hospitalization cost of employees is between 40,000 yuan and 100,000 yuan, the reimbursement ratio is 95%;
4. If the hospitalization expenses of employees are between 100,000 yuan and 300,000 yuan, the reimbursement ratio is 85%.
In addition, for different levels of cities, such as first-class, second-class, and first-class medical institutions, the reimbursement ratio is also different, generally between 85% and 97%.
Warm reminder, the specific reimbursement ratio of employee medical insurance may vary depending on the region, hospital, individual situation and other factors. It is recommended to consult the local medical insurance department or the relevant department of the hospital to obtain the most accurate reimbursement ratio information.