Core Insights - The article highlights the importance of secondary reimbursement in China's medical insurance system, which is often overlooked by insured individuals, leading to significant financial losses [3][6]. Group 1: Current Status of Secondary Reimbursement - As of the first quarter of 2025, only 27.3% of eligible medical expenses were actually claimed for secondary reimbursement, indicating a lack of awareness among insured individuals [3]. - The secondary reimbursement system is part of a multi-tiered medical insurance framework, including major illness insurance, medical assistance, supplementary medical insurance, and employee personal accounts [4][5]. Group 2: Mechanisms of Secondary Reimbursement - Major illness insurance allows for reimbursement of 50% of medical expenses exceeding 50% of the local per capita disposable income, with no cap on the reimbursement amount [4]. - Medical assistance provided 873 billion yuan in funding in 2024, benefiting nearly 39.67 million people, with additional support for low-income households [4]. - Supplementary medical insurance has been established in 27 provinces, increasing reimbursement rates from 50% to an average of 70% for outpatient services [4]. Group 3: Challenges in Awareness and Application - A survey indicated that only 36% of insured individuals had a basic understanding of secondary reimbursement policies, and only 22% were aware of the specific application process [6]. - The complexity of the application process, requiring various documents and differing policies across regions, contributes to the low application rates [6]. Group 4: Efforts to Simplify Processes - The National Medical Insurance Administration has implemented a one-stop settlement reform, with 219 cities achieving this by June 2025, allowing for automatic calculation and settlement of various insurance claims [7]. Group 5: Maximizing Secondary Reimbursement Benefits - Insured individuals are encouraged to actively seek information about policies, retain all medical receipts, and inquire about eligibility for secondary reimbursement during hospital visits [9]. - Special provisions exist for certain demographics, such as higher reimbursement rates for individuals under 25 and additional benefits for seniors over 65 [9]. Group 6: Future Outlook and Policy Optimization - The 2025 work plan aims to increase the reimbursement rate for major illness insurance, lower the threshold for claims, and simplify application procedures, with a target of raising the application rate to over 50% [11]. - The total scale of the national medical insurance fund reached 3.2 trillion yuan in 2024, with 6.3% allocated for secondary reimbursement, indicating a focus on improving fund efficiency [11].