Is there a difference between medical insurance for urban workers and social security?

Insurance Bian Xiao helps you answer, and more questions can be answered online.

Hello! Medical insurance for urban workers means medical insurance for urban workers. All employers and their employees in cities and towns should participate in basic medical insurance and implement territorial management. The basic medical insurance premium is shared by both the employer and the employee; The basic medical insurance fund combines social pooling with individual accounts. Social security, that is, social insurance, is a social and economic system that provides income or compensation for people who have lost their ability to work, are temporarily unemployed or suffer losses due to health reasons. The main items of social insurance include old-age social insurance, medical social insurance, unemployment insurance, industrial injury insurance, maternity insurance, etc. There are differences between medical insurance for urban workers and social security, mainly in the differences between medical insurance for urban workers and basic medical insurance for urban residents.

The differences between the basic medical insurance for employees and the basic medical insurance for urban residents in terms of treatment are as follows:

1, the scope of enjoyment is different: employees' medical insurance can't enjoy the reimbursement of hospitalization maternity medical care; Staff and workers enjoy 17 diseases for serious illness (serious illness) in outpatient service, and residents enjoy 8 diseases.

2. Different reimbursement rates: First, different reimbursement rates for hospitalization. The reimbursement rate of employees in medical insurance is 92% for Class A and 70-80% for Class B; The reimbursement rate of retired workers in hospital is 92% for Class A and 70-80% for Class B. The reimbursement rate of residents in medical insurance is 80% and 70% for first-class hospitals, 70% and 60% for second-class hospitals and 60% and 50% for second-class hospitals. Second, the proportion of reimbursement for serious chronic diseases (serious illnesses) is different: the proportion of reimbursement for medical insurance for employees is 75%, and that for residents is 50%.

3. The maximum payment limit of pooling funds and large medical insurance is different. The maximum payment limit of the basic medical insurance fund for employees is 4 times of the average salary of employees in the previous year, and the maximum payment limit of large medical insurance is 300,000 yuan 2011; The maximum payment limit of urban residents' basic medical insurance co-ordination fund is four times of the annual disposable income of residents in this area, and the maximum payment limit of large medical insurance is 20 1 1 80,000 yuan.