On the issue of social security, the minimum reimbursement limit and the maximum reimbursement limit for serious illness

Taking salary as a parameter, the unit payment amount is: payment salary ×7.5%, and individual payment: payment salary ×2% (this is the medical insurance premium deducted from your salary every month).

2. How much is the social security card per month?

We often buy medicine by credit card, and there will be a small amount of money transferred from medical insurance on the social security card every month. How much is this?

On-the-job employees under 50 years old: payment salary ×2%+ payment salary × age × 0.02%;

On-the-job employees over 50 years old: payment salary ×2%+ payment salary × age × 0.035%;

3. How much can medical insurance report if you are sick?

First of all, you can only report if you are hospitalized in a designated medical institution with medical insurance. Secondly, the reported medical expenses must conform to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and payment standards.

The reimbursement standard is: the total amount of one-time hospitalization medical expenses-Qifubiaozhun-expenses beyond the basic medical scope-20% of the expenses paid by individuals in advance × [(75+age× 0.2)/100].

At the same time, minor illnesses are not reimbursed, and there is a minimum payment standard: the minimum payment standard for the first-level hospital inpatient pooling fund is 360 yuan; 580 yuan, a secondary hospital; 970 yuan, a tertiary hospital; There is no level of community health service center hospitalization pooling fund Qifubiaozhun for 360 yuan. Qifubiaozhun of hospitalization pooling fund is calculated on a per-time basis. In a natural year, if you stay in a hospital above the second level for many times (including outpatient special diseases and family sickbeds), you will be exempted from 100 yuan, with a minimum of not less than 360 yuan.

In addition, there is a maximum social security payment. For example, the highest payment in Chengdu in 2006 was four times the average wage of Chengdu employees in 2005, 69 17279 yuan and 69 165438 yuan.

4. Can medical insurance be transferred in different places?

You can't transfer, you can only re-enroll. At present, the only social security that can be transferred is endowment insurance.

5. How many years should I pay for medical insurance? What should I do in the middle? Can I pay it back?

Continuous payment for more than fifteen years, continuous payment, the overall medical fund payment treatment in accordance with the provisions. Those who have been insured for more than two months must be hospitalized after 12 months from the date of re-insurance, and the medical fund will begin to pay the treatment. The basic medical insurance cannot be paid; When reaching the statutory retirement age, if the accumulated payment period of basic medical insurance premium is less than 15 years, the payment shall be continued according to the regulations, so that the accumulated payment period will reach 15 years.

In other words, as long as it is broken for two months, it will be effective after one year. You must pay attention to changing jobs.

6. What can I do if I am hospitalized?

You need to hold an ID card when you are hospitalized, and the social security card can be used directly when you are hospitalized. You can directly complete the reimbursement and settlement of hospitalization expenses when you leave the hospital. If you can't swipe your card for hospitalization due to special circumstances, you need to go to the Municipal Social Security Bureau with your ID card, social security card and admission ticket within three days of admission, and complete the reimbursement and settlement of hospitalization expenses directly in the hospital after discharge. If you can't handle the special account form for special reasons, you need to pay the hospitalization expenses in full first, and then submit my ID card, social security card, discharge certificate, list, invoice reimbursement and original compound prescription to the Social Security Bureau for reimbursement of medical expenses after discharge. After discharge, those who stay in the city for more than two months and stay outside the city for more than three months will not be settled.

7. How to reimburse medical expenses incurred in other places?

Reimbursement of expenses shall be implemented in accordance with the specific provisions of the medical insurance measures at the place where the insured is located. Generally, in the case of rescue, the nearest diagnosis and treatment is allowed. After treatment, with the valid certificate issued by the treatment hospital, the local medical insurance agency will be reimbursed according to the regulations.

8. After buying basic medical insurance or supplementary medical insurance, how long can I enjoy medical reimbursement?

The company bought medical insurance, but do you know what the medical insurance method is, how much you pay, how much the company pays, how much you can get when you get sick, how long it takes, how to transfer, and how to get medical insurance for your children? Let's talk about it item by item.

1. How much should I pay for medical insurance?

Taking salary as a parameter, the unit payment amount is: payment salary ×7.5%, and individual payment: payment salary ×2% (this is the medical insurance premium deducted from your salary every month).

2. How much is the social security card per month?

We often buy medicine by credit card, and there will be a small amount of money transferred from medical insurance on the social security card every month. How much is this?

On-the-job employees under 50 years old: payment salary ×2%+ payment salary × age × 0.02%;

On-the-job employees over 50 years old: payment salary ×2%+ payment salary × age × 0.035%;

3. How much can medical insurance report if you are sick?

First of all, you can only report if you are hospitalized in a designated medical institution with medical insurance. Secondly, the reported medical expenses must conform to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and payment standards.

The reimbursement standard is: the total amount of one-time hospitalization medical expenses-Qifubiaozhun-expenses beyond the basic medical scope-20% of the expenses paid by individuals in advance × [(75+age× 0.2)/100].

At the same time, minor illnesses are not reimbursed, and there is a minimum payment standard: the minimum payment standard for the first-level hospital inpatient pooling fund is 360 yuan; 580 yuan, a secondary hospital; 970 yuan, a tertiary hospital; There is no level of community health service center hospitalization pooling fund Qifubiaozhun for 360 yuan. Qifubiaozhun of hospitalization pooling fund is calculated on a per-time basis. In a natural year, if you stay in a hospital above the second level for many times (including outpatient special diseases and family sickbeds), you will be exempted from 100 yuan, with a minimum of not less than 360 yuan.

In addition, there is a maximum social security payment. For example, the highest payment in Chengdu in 2006 was four times the average wage of Chengdu employees in 2005, 69 17279 yuan and 69 165438 yuan.

4. Can medical insurance be transferred in different places?

You can't transfer, you can only re-enroll. At present, the only social security that can be transferred is endowment insurance.

5. How many years should I pay for medical insurance? What should I do in the middle? Can I pay it back?

Continuous payment for more than fifteen years, continuous payment, the overall medical fund payment treatment in accordance with the provisions. Those who have been insured for more than two months must be hospitalized after 12 months from the date of re-insurance, and the medical fund will begin to pay the treatment. The basic medical insurance cannot be paid; When reaching the statutory retirement age, if the accumulated payment period of basic medical insurance premium is less than 15 years, the payment shall be continued according to the regulations, so that the accumulated payment period will reach 15 years.

In other words, as long as it is broken for two months, it will be effective after one year. You must pay attention to changing jobs.

6. What can I do if I am hospitalized?

You need to hold an ID card when you are hospitalized, and the social security card can be used directly when you are hospitalized. You can directly complete the reimbursement and settlement of hospitalization expenses when you leave the hospital. If you can't swipe your card for hospitalization due to special circumstances, you need to go to the Municipal Social Security Bureau with your ID card, social security card and admission ticket within three days of admission, and complete the reimbursement and settlement of hospitalization expenses directly in the hospital after discharge. If you can't handle the special account form for special reasons, you need to pay the hospitalization expenses in full first, and then submit my ID card, social security card, discharge certificate, list, invoice reimbursement and original compound prescription to the Social Security Bureau for reimbursement of medical expenses after discharge. After discharge, those who stay in the city for more than two months and stay outside the city for more than three months will not be settled.

7. How to reimburse medical expenses incurred in other places?

Reimbursement of expenses shall be implemented in accordance with the specific provisions of the medical insurance measures at the place where the insured is located. Generally, in the case of rescue, the nearest diagnosis and treatment is allowed. After treatment, with the valid certificate issued by the treatment hospital, the local medical insurance agency will be reimbursed according to the regulations.

8. After buying basic medical insurance or supplementary medical insurance, how long can I enjoy medical reimbursement?

Units participating in the basic medical insurance will take effect the following month; If it is an individual insured, it will take effect one year later. It will take effect one or two years after the purchase of supplementary medical insurance, and three or six months after the purchase of supplementary medical insurance.

9. How to pay maternity insurance and how to reimburse it?

Pay maternity insurance in full and on time 12 months, and you can enjoy maternity insurance benefits. After the child is born, the reimbursement amount is half of the average annual salary of the previous year.

10, Children's Common Fund

Payment can be made at the community health service center, health center, child health care and planned immunization institution where the household registration or residence is located. 40 yuan's amount, after you pay, the charging unit will give you a medical certificate stamped with the chapter of children's hospitalization mutual aid. When in hospital, take the diagnosis certificate, ID card or household registration book to the designated hospital for treatment. When leaving the hospital, the hospital will automatically deduct the part of the mutual fund that should be subsidized when settling the expenses.

Children diagnosed with illness can also join, with a maximum limit of 80,000 yuan.

Units participating in the basic medical insurance will take effect the following month; If it is an individual insured, it will take effect one year later. It will take effect one or two years after the purchase of supplementary medical insurance, and three or six months after the purchase of supplementary medical insurance.

9. How to pay maternity insurance and how to reimburse it?

Pay maternity insurance in full and on time 12 months, and you can enjoy maternity insurance benefits. After the child is born, the reimbursement amount is half of the average annual salary of the previous year.

10, Children's Common Fund

Payment can be made at the community health service center, health center, child health care and planned immunization institution where the household registration or residence is located. 40 yuan's amount, after you pay, the charging unit will give you a medical certificate stamped with the chapter of children's hospitalization mutual aid. When in hospital, take the diagnosis certificate, ID card or household registration book to the designated hospital for treatment. When leaving the hospital, the hospital will automatically deduct the part of the mutual fund that should be subsidized when settling the expenses.

Children diagnosed with illness can also join, with a maximum limit of 80,000 yuan.