The following is taken from the Notice of Zhaodong Municipality on Basic Medical Insurance for Urban Residents this year:
2, one fee and two risks.
Participated in medical insurance for urban residents, and at the same time can enjoy the policy treatment of supplementary insurance for serious illness for urban residents. That is, part of the medical expenses within the scope of more than 20 thousand paid by individuals will be reimbursed twice according to the policy. The specific treatment is as follows:
(1) The deductible standard for supplementary insurance for serious illness of urban residents is tentatively set at 20,000 yuan.
(2) After the hospitalization expenses and chronic disease outpatient medical expenses incurred by the insured are reimbursed according to the urban residents' medical insurance policy, and the medical expenses paid by individuals belonging to the basic medical insurance drug list, the scope of diagnosis and treatment items, the scope of medical service facilities and the payment standard reach the deductible line, the supplementary insurance for serious illness will be reimbursed in stages.
For eligible medical expenses paid by individuals, above the deductible line, 40% will be reimbursed for 0 to 50,000 yuan (inclusive), 50% for 50,000 yuan to 6,543.8 million yuan (inclusive), 60% for 6,543.8 million yuan to 200,000 yuan (inclusive), and 654.38+ for more than 200,000 yuan.
(three) during the interruption of the basic medical insurance benefits for urban residents, they do not enjoy the supplementary insurance benefits for serious illness, and the medical expenses incurred during the period are not included in the personal out-of-pocket expenses of the year.