What is the difference between urban and rural medical insurance and urban medical insurance?

The insured persons of medical insurance for urban and rural residents are mainly rural residents, unemployed urban residents, students at school, permanent residents who have obtained residence permits in the overall planning area (/kloc-children under 0/2 years old, whose guardians have household registration or residence permits in the overall planning area, which can be regarded as obtaining residence permits), unemployed Hong Kong, Macao and Taiwan residents who live in the mainland (mainland) and apply for residence permits for Hong Kong, Macao and Taiwan residents, and Hong Kong, Macao and Taiwan college students studying in the mainland (mainland).

The insured population of medical insurance for urban workers are on-the-job workers, flexible employees and individual industrial and commercial households.

2. The payment situation is different

Medical insurance for urban and rural residents shall be paid annually and guaranteed for one year at a time. Residents will pay their own expenses, and they will also enjoy certain government subsidies. In 2022, the standard of financial subsidy for medical insurance for urban and rural residents in Shaanxi Province is 6 10 yuan per person per year, and the standard of individual insurance payment is 350 yuan per person per year.

Medical insurance for urban workers shall be paid on a monthly basis, and the payment of unit employees shall be withheld and remitted by the unit on a monthly basis, and the expenses shall be paid jointly by the unit and the individual; The medical insurance expenses of flexible employees shall be borne by individuals in full, and eligible persons may apply for medical insurance to pay subsidies.

3, the degree of protection is different

Medical insurance reimbursement for urban and rural residents is relatively low. At present, the reimbursement rate of medical insurance hospitalization expenses for Shaanxi residents is stable at around 70%.

Medical insurance for urban workers is relatively high. In 2022, the Qifubiaozhun of tertiary hospitals for employees in Xi reached 1 10,000 yuan, and the reimbursement rate was 88%, and the reimbursement rate from 1 10,000 yuan to 50,000 yuan was 9 1%. Within one year, 95% of the medical expenses incurred by the insured employees who are hospitalized due to illness and meet the requirements of medical insurance and exceed the maximum payment limit of basic medical insurance for urban employees (400,000 yuan) will be paid by the large Medicaid insurance for urban employees, and there is no capping line.

4. Different medical insurance accounts.

Urban and rural residents' medical insurance canceled their personal accounts, and all the money paid by the insured was included in the overall account. The resident medical insurance card is used to enjoy the settlement and reimbursement of outpatient expenses through outpatient co-ordination.

Medical insurance for urban workers includes overall account and individual account. All the basic medical insurance premiums paid by the employer are used to establish a unified fund, and all the basic medical insurance premiums paid by employees are included in personal accounts. In other words, the personal account will return a certain amount of money every month according to the situation, which can be used to pay when seeing a doctor.

However, no matter which basic medical insurance you choose, you can't participate in the insurance again, that is, the insured has two or more insurance information with normal insurance payment status at the same time. Repeated insured persons cannot enjoy medical insurance benefits repeatedly, and enjoy corresponding medical insurance benefits according to the principles of giving priority to employees' medical insurance, giving priority to college students' medical insurance and giving priority to permanent residence medical insurance.

Legal basis:

"People's Republic of China (PRC) Social Insurance Law" Article 24 The state establishes and improves the new rural cooperative medical system. Measures for the administration of the new rural cooperative medical system shall be formulated by the State Council.

People's Republic of China (PRC) Social Insurance Law Article 25 The State establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.