How to reimburse the part of social security exceeding 1800?

The outpatient and emergency medical expenses that meet the requirements of social security are above 1.800 yuan every year, and 50% are reimbursed in designated non-community medical institutions and 70% in the community.

If this is the first reimbursement this year, the medical expenses incurred will be 2,000 yuan after deducting social security self-funded and self-funded items, of which 1.800 yuan cannot be reimbursed, and 200 yuan is multiplied by 50% non-community or 70% community to get 1.000 yuan or 1.40 yuan. The maximum social security reimbursement is 20,000 yuan.

Social security is divided into units and individuals. The specific social security contributions are: endowment insurance, with units and individuals paying 20% and 8% respectively; Medical insurance, units and individuals pay 12% and 2% respectively; Unemployment insurance, units and individuals pay 2% and 0% respectively; Maternity insurance units pay 0.60%, and individuals do not pay; Work-related injury insurance units pay 2%, and individuals do not pay.

Extended data:

Social security financial system

1, pay-as-you-go system

Pay-as-you-go system refers to a financial system that uses the insurance premiums collected in the current period for the current payment, so that the insurance financial revenue and expenditure are generally balanced. In addition to pension insurance projects, general social security projects adopt this financial system.

The adoption of this system in endowment insurance has advantages and disadvantages. The biggest advantage of the pay-as-you-go system is that the rate calculation is simple, and at the same time, because there is no huge capital, there will be no pressure to maintain and increase value, and it will not be adversely affected by currency depreciation. But the shortcomings of this system are also obvious.

We must always reassess the financial structure and adjust interest rates. Generally speaking, due to the aging population structure and the rigidity of welfare level, the rate is generally increasing day by day.

At the same time, from the perspective of distribution relationship, in the aspect of endowment insurance, the pay-as-you-go system is essentially a redistribution relationship between generations, and the increase in rates will deepen intergenerational contradictions and cause political problems.

2. Complete accumulation system

This system is a financial system that determines an average rate that can ensure a long-term balance of payments after long-term calculation of related factors that affect the rate, and forms all insurance premiums (taxes) into social insurance funds. This financial system is widely used in the personal account plan of endowment insurance under the framework of enterprise annuity system and social insurance system.

The most obvious advantage of this system is that due to the accumulation of funds, the insurance premium rate can remain relatively stable in the case of an aging population. But this advantage is based on the premise that the fund's rate of return is higher than the wage growth rate.

The defects of this system are also obvious. First of all, a higher speed is needed in the initial stage of system operation; Second, the fund faces enormous inflationary pressure. If the fund is used properly, not only the social insurance system will benefit from it, but also the whole economy will benefit from the effective allocation of the fund. On the other hand, if the fund can't maintain and increase its value, the cost of this system is higher than the pay-as-you-go system.

3. Partial accumulation system

This system is a mixture of pay-as-you-go system and full accumulation system. At first, its rate was higher than the pay-as-you-go system and lower than the full accumulation system. In terms of reserves, it will be higher than the pay-as-you-go system and lower than the total accumulation system.

This system is to find a middle way to meet the aging population and the initial high premium system. The usual practice is to accumulate a small part of the premium paid by the original pay-as-you-go system in the personal account system, or increase the rate on the basis of the original system and accumulate all the incremental parts in the personal account system. This system also faces the problems of fund management and value preservation and appreciation.

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