Legal analysis: (1), the outpatient service (1) uses the medical insurance card to see a doctor in the outpatient service, and it is settled in real time without reimbursement. (2) Please use the medical insurance manual (medical blueprint) for outpatient treatment without medical insurance card. 1. Reimbursement scope: general outpatient and emergency expenses incurred by the insured in designated hospitals or specialized hospitals, traditional Chinese medicine hospitals and tertiary hospitals selected by individuals. 2. Outpatient deductible line: the total emergency expenses of general outpatient service exceed 1.800 yuan in a natural year. 3. Reimbursement ratio: 70% for the hospital, 90% for the community, and the top line: 20,000 yuan. (2) Hospitalization 1. Reimbursement scope: hospitalization expenses incurred by the insured in designated hospitals or specialized hospitals, traditional Chinese medicine hospitals and 3A hospitals selected by individuals. 2. Inpatient deductible line: The standard of the first hospitalization deductible line in a natural year is 1.300 yuan, with 650 yuan as the unit each time. 3. Reimbursement ratio: 90% in the first-class hospital, 87% in the second-class hospital and 85% in the third-class hospital, with a total reimbursement of 300,000 yuan for hospitalization.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.