Is there more social security reimbursement or medical insurance reimbursement?

Medical insurance is as much as social security reimbursement. Social security includes endowment insurance, medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, and medical insurance is a part of social security. If it is reimbursement of medical accidents, medical insurance is reimbursed as social security.

Social security, also known as social insurance, is a social and economic system that compensates for the loss of working ability, temporary loss of jobs and losses caused by health. Medical insurance is an important part of social security, and employees can be sold and treated according to unified standards, without any difference. The reimbursement rate of employees in hospital is 654.38+100000 yuan, and the reimbursement rate of tertiary hospitals is 86%; 65,438+0,000 to 20,000 yuan, and 88% of the expenses are reimbursed by tertiary hospitals; 20,000 to 40,000 yuan, and 92% of the expenses are reimbursed by tertiary hospitals. The medical amount on the medical insurance card can be accumulated. If employees are healthy every year, a lot of money will be accumulated on the medical insurance card.

There is also an obvious disadvantage of medical treatment, that is, there is a basic deductible, which is 1000 yuan for the first-class hospital in 500 yuan, the second-class hospital in 750 yuan and the third-class hospital. The expenses of deductible shall be borne by the employees themselves. Class A drugs and Class B drugs are reimbursed in proportion, and imported drugs are not reimbursed. If Class A and Class B drugs exceed the insured amount of 40,000 yuan, employees should pay their own money. The medical insurance card can not only reimburse medical expenses, but also buy medicines in retail pharmacies.

Social security card reimbursement is generally proportional, generally 60%-70%.

1. In a settlement year, medical expenses less than 654.38+10,000 yuan that meet the scope of reimbursement occurred. The threshold for tertiary hospitals is 659 yuan, the reimbursement ratio is 50%, and the upper limit is 2,000 yuan; The Qifubiaozhun for hospitalization in secondary hospitals is 300 yuan, and the reimbursement rate is 55%; There is no Qifubiaozhun in first-class hospitals, and the reimbursement rate is 60%.

2. The reimbursement rate of social security card hospitalization is: 90% in the first-class hospital, 87% in the second-class hospital and 85% in the third-class hospital, with a total hospitalization reimbursement of 300,000 yuan. Inpatient deductible line: The standard of the first hospitalization deductible line in a natural year is 1.300 yuan, with 650 yuan as the unit each time.

3. Continuous payment is linked to the reimbursement ratio. After two years of continuous insurance, the reimbursement rate increased to 765,438+0%, and after four years of continuous insurance, the reimbursement rate increased to 72%, and so on. It should be reminded that in different cities, the reimbursement ratio of social security cards is different, which is mainly related to the local medical insurance benefits.

To sum up, social security includes endowment insurance, medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, and medical insurance is a part of social security. If it is reimbursement of medical accidents, medical insurance is reimbursed as social security.

Legal basis:

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

second

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to get material help from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Article 4

Employers and individuals who pay social insurance premiums according to law have the right to inquire about payment records and personal rights records, and require social insurance agencies to provide social insurance consulting and other related services.

Article 28

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.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.