Minimally invasive breast surgery medical insurance out-of-pocket expense ratio

It needs to be determined according to the patient's specific situation, for example, if it is a rural area health insurance reimbursement, may be in the 45%, but if it is an employee health insurance, usually in the 89%, if it is a retired employee health insurance, the reimbursement rate will be a little higher, different places have different ratios.

Generally speaking, the economic development of different regions is different, so the reimbursement rate also varies, with the Beijing employee health insurance rate situation for example;

If you are an active employee, you can only be reimbursed for medical expenses of more than 1,800 yuan after visiting outpatient clinics and emergency clinics in hospitals, and the reimbursement rate is 50 percent. In the case of retirees under the age of 70, expenses above $1,300 are reimbursed, and the reimbursement rate is 70 percent. In the case of retirees over 70 years old, expenses over $1,300 can be reimbursed the reimbursement rate is 80 percent;

And regardless of the category of people, the maximum limit of outpatient and emergency large medical expenses paid for the expenses is 20,000 yuan. In the case of hospitalized expenses, the starting amount is 1,300 yuan for the first time when basic medical insurance is used to pay in a year in 2009, regardless of whether the person is an active employee or a retiree. And for the second and subsequent hospitalization medical expenses, the starting amount is determined at 50%, which is 650 RMB. And the maximum payment amount of the basic medical insurance coordinating fund (hospitalization expenses) in 1 year is 70,000 yuan;

The standard of hospitalization reimbursement is related to the level of the hospital that the participant is staying in, such as staying in a tertiary hospital, the employee pays 15%, or reimbursement of 85% of the expenses from the starting standard to 30,000 yuan; for the expenses from 30,000 yuan to 40,000 yuan, the employee pays 10%, or reimbursement of 90%; for the expenses exceeding 40,000 yuan to the portion of the maximum payment limit, then 95 percent is reimbursed, and the employee pays only 5 percent. And retirees pay 60 percent of what active (that's what's mentioned above) employees pay individually, but anything below the threshold is paid by the individual.

Legal basis:

The Social Insurance Law of the People's Republic of China

Article 29: The portion of the medical expenses of the insured that shall be paid by the basic medical insurance fund shall be settled directly by the social insurance administration organization with 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.

Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be carried out in accordance with state regulations.