What is the proportion of employee social security reimbursement?

The proportion of social security reimbursement for employees refers to the standard that the social security fund reimburses medical expenses and work-related injury expenses according to a certain proportion when employees enjoy social insurance benefits.

First, the proportion of medical insurance reimbursement

Medical insurance is an important part of the social security system for employees, and its reimbursement ratio is directly related to the burden of medical expenses for employees. Generally speaking, after employees participate in medical insurance, their medical expenses can be reimbursed in accordance with the prescribed proportion. The specific reimbursement ratio usually includes two parts: outpatient medical expenses reimbursement ratio and inpatient medical expenses reimbursement ratio. The reimbursement rate of outpatient medical expenses is generally low, while the reimbursement rate of inpatient medical expenses is relatively high. However, the specific reimbursement ratio will be adjusted according to the policies and regulations of different regions.

Second, the proportion of work-related injury insurance reimbursement

Industrial injury insurance aims to provide financial protection for employees who suffer accidental injuries or occupational diseases at work. The reimbursement ratio of work-related injury insurance usually involves work-related injury medical expenses, disability allowance and one-time work-related injury medical subsidy. For the medical expenses of work-related injuries, the social security fund usually bears most of the expenses, and the specific reimbursement ratio will be determined according to the degree of work-related injuries, treatment costs and other factors.

Third, the proportion of maternity insurance reimbursement

Maternity insurance aims to protect the medical and living expenses of female employees during childbirth. The reimbursement ratio of maternity insurance usually includes the reimbursement of prenatal examination expenses, delivery expenses and hospitalization expenses. The specific reimbursement ratio will vary according to different regions and hospital levels, but generally speaking, the social security fund will reimburse a certain proportion of the maternity expenses that meet the requirements.

Four, other social security projects reimbursement ratio

In addition to medical insurance, industrial injury insurance and maternity insurance, the social security system for employees also includes pension insurance and unemployment insurance. The reimbursement ratio of these projects will also vary according to specific policies and regulations. For example, the reimbursement ratio of old-age insurance is usually related to the payment period and amount of employees, while the reimbursement ratio of unemployment insurance is related to the unemployment period and reasons of unemployed people.

To sum up:

The proportion of employees' social security reimbursement is determined according to the policies and regulations of various social insurance projects, and the specific proportion will be different according to different regions, insurance projects and personal conditions. When employees enjoy social security benefits, they should understand and abide by relevant policies and regulations to ensure that their rights and interests are protected.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 27 provides that:

Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.

Article 28 provides that:

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.