First, the proportion of outpatient and emergency reimbursement

1, community health service center (or first-class medical institutions) outpatient emergency, reimbursement of 70%;

2. 60% reimbursement for outpatient emergency in secondary medical institutions;

3, in the outpatient emergency of tertiary medical institutions, pay 50%.

Second, the proportion of hospitalization reimbursement

1, community health service center (or first-class medical institutions) hospitalization payment of 90%;

2, two medical institutions to pay 80% of hospitalization;

3. 70% for hospitalization in tertiary medical institutions;

4. Persons under 60 years of age

① 80% for hospitalization in community health service centers (or first-class medical institutions);

② 75% for hospitalization in secondary medical institutions,

③ 60% for hospitalization in tertiary medical institutions.

Proportion of medical insurance payment in Shanghai

The contribution rate of employers in Shanghai medical insurance is 1 1%, and the individual contribution rate is 2%.

Remarks:

1, the employer's contribution ratio 1 1% includes 9% of the basic medical insurance premium paid by the unit and 2% of the local additional medical insurance premium paid by the unit.

2. The payment base of medical insurance for employees who originally participated in social insurance in small towns is 28 15 yuan, and the employer and its employees can also participate in the payment according to the provisions of social insurance for urban employees in this Municipality through consultation.

3. The payment base and payment proportion of non-urban household registration foreign employees can be paid according to 50% of the average monthly salary of employees in the whole city in the previous year, and can also be paid according to the provisions of social insurance for urban employees in this city through consultation between employers and their employees.

Shanghai medical insurance payment base

1, upper limit of Shanghai medical insurance payment base: 28 15 yuan.

2. Lower limit of Shanghai medical insurance payment base: 14076 yuan.

Shanghai medical insurance qifubiaozhun

First, the outpatient Qifubiaozhun

1, persons aged 60 and above, severely disabled persons, primary and secondary school students and infants are 300 yuan;

2. People over 18 years old and under 60 years old are 500 yuan.

Second, the hospitalization Qifubiaozhun

1, 50 yuan, a first-class medical institution;

2, secondary medical institutions 100 yuan;

3. 300 yuan, a tertiary medical institution.

Shanghai medical insurance payment standard

1, for people over 70 years old, the financing standard is 3,800 yuan per person per year, of which the individual pays 340 yuan;

2, 60-69-year-old personnel, the financing standard is 3,800 yuan per person per year, of which the individual pays 500 yuan;

3, 19-59 years old, the financing standard is 2,500 yuan per person per year, of which the individual pays 680 yuan;

4. For primary and secondary school students and infants, the funding standard is 900 yuan per person per year, of which the individual contribution is 100 yuan.