Medical insurance related policy knowledge

Original "Social Insurance Regulations and Policies", please read carefully in your busy schedule:

1. Social insurance is a public welfare social security organized by the state.

1. The state develops social insurance and establishes a social insurance system to enable workers to receive help and compensation in cases of old age, illness, work injury, unemployment and childbirth.

2. Employers and workers must participate in social insurance and pay social insurance premiums in accordance with the law.

2. Types of social insurance:

1. Pension insurance; 2. Unemployment insurance; 3. Medical insurance; 4. Worker's compensation insurance; 5. Maternity insurance.

Third, the contribution base:

Employers and workers **** the same social insurance premiums, the worker's province in the previous year the province's average monthly wages of on-the-job workers 60%-300% (in some places 40%-300%) as the contribution base, payable on a monthly basis.

Four, unit employees to participate in the insurance and contribution ratio:

1. Pension insurance premiums: the unit to pay 20%, individuals pay 8%.

2. Unemployment insurance premiums: the unit pays 2%, the individual pays 1%.

3. Medical insurance premiums: 8% for the unit and 2% for the individual.

4. Worker's compensation insurance: the unit pays, the individual does not pay.

5. Maternity insurance premiums: the unit pays, individuals do not pay.

5. The types of insurance and the percentage of contribution in the individual capacity:

1. Pension insurance premiums: Individuals pay 20%.

2. Medical insurance premiums: individuals pay 5%.

6. 2 conditions for retirement to receive social security pension:

1. The actual contribution period of the participant is more than 10 years (for those who joined the workforce on or before September 30, 1998) or 15 years (for those who joined the workforce on or after October 1, 1998);

2. The participant reaches the legal retirement age.

VII. Current statutory retirement age:

1. Women: 50 years old for workers; 55 years old for managers. Individuals who are insured are always 55 years old.

2. Men: all 60 years old. There is no distinction between workers, managers, units insured and individuals insured.

3. Among them, workers engaged in underground, high altitude, high temperature, especially heavy physical labor or other work harmful to health, perennial in the altitude of more than 3,500 meters above sea level plateau area and perennial in the cold storage, production workshops and other low-temperature places below zero degrees Celsius, can be retired early.

Eight, 3 factors affecting the amount of retirement pension:

1. Retirement of the previous year's provincial wage (provincial wage increases every year, the pension is also rising year by year. Therefore, the later you retire, the more your pension will be);

2. The number of years you have contributed (the longer you have contributed, the more your pension will be);

3. The amount of money stored in your personal account (the more you have contributed, the more you will be paid).

9. The health insurance benefits are divided into general disease health insurance, chronic disease outpatient health insurance and hospitalization health insurance for major diseases:

1. General disease health insurance:

a. Outpatient expenses cannot be reimbursed.

b. Hospitalization costs are reimbursed at about 80%, with the individual bearing about 20. Reimbursement is capped at tens of thousands of dollars.

2. Outpatient medical insurance for chronic diseases: outpatient expenses can be reimbursed.

3. Inpatient medical insurance for major diseases: 80% of hospitalization costs are reimbursed, and individuals bear about 20%. The maximum amount of reimbursement is more than 100,000 yuan.

Ten, stop insurance, transfer, surrender, inheritance:

1. Stop insurance: you can stop insurance and then renew it, but only stop reimbursement of medical expenses from the next month of stopping insurance.

2. Transfer: It is no problem to transfer to the same city (switching units or switching to individual contributions), while transferring to another place requires confirmation from the social security center of the transferring place.

3. Withdrawal: Agricultural households can withdraw from the program, while urban households cannot.

4. Inheritance: If a participant dies before retirement, the amount of the individual account for pension and medical insurance will be inherited by the legal heirs.