Outpatient reimbursement:

1, 35% of medical expenses are insufficient 1000 yuan (excluding);

2. Medical expenses ranging from 1000 yuan (inclusive) to 5,000 yuan (exclusive) will be reimbursed by 45%;

3, medical expenses in 5000 yuan (inclusive) to 10000 yuan (exclusive), 55% reimbursement;

4, medical expenses in 10000 yuan (inclusive) above, 65% reimbursement.

Hospitalization reimbursement:

1, medical expenses 10000 yuan (excluding), and the reimbursement rates are 55%, 65% and 75% respectively in tertiary, secondary and primary medical institutions;

2. Medical expenses range from 10000 yuan (inclusive) to 20000 yuan (exclusive). In tertiary, secondary and primary medical institutions, the reimbursement rates are 60%, 70% and 80% respectively;

3, medical expenses in more than 20000 yuan (inclusive), in the tertiary, secondary and primary medical institutions, the reimbursement rate is 65%, 75% and 85% respectively.

How to reimburse medical insurance for college students is as follows:

1. When students seek medical treatment in school health centers and hospitals, they can enjoy instant preferential settlement with their student ID cards and ID cards.

2. The materials to be prepared for reimbursement of general outpatient examination expenses incurred by students seeking medical treatment outside the school include: valid invoices of designated hospitals for medical insurance, original detailed list of examination expenses, original proof of disease diagnosis, original medical records and related lists, which are submitted to the higher authorities for approval after being audited by the school hospital, and the financial department will transfer the reimbursement expenses to the student account through bank transfer.

3. When a student is hospitalized outside the school, the materials to be prepared for reimbursement include: valid invoice during hospitalization, summary list of expenses during hospitalization, discharge summary, copy of ID card and bank card, and proof of transfer to the First Hospital for medical treatment. College students' medical insurance office will sort it out and send it to the medical insurance center for reimbursement. After the medical insurance center accepts and passes the examination, the reimbursement fee will be transferred to the student's personal bank account.

To sum up, the medical expenses incurred by the insured students in the first-level medical institutions and pharmacies designated by medical insurance are reimbursed for 500 to 3,000 yuan. The focus of residents' medical insurance is to ensure serious illness. Students' medical insurance benefits refer to the high-level medical insurance benefits of adult residents. 500 yuan above to 6.5438+0.8 million yuan, 80% of the first-class hospitals, 75% of the second-class hospitals and 65% of the third-class hospitals. In addition, insured students also enjoy reimbursement of residents' serious illness insurance.

Legal basis:

Article 30 of People's Republic of China (PRC) Social Insurance Law

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

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.