Social security in Sichuan. What are the rules for medical insurance?

Original: The encyclopedia of social insurance laws and policies, please read it carefully in your busy schedule.

First, social insurance is a public welfare social security organized by the state.

1. The state develops social insurance, establishes a social insurance system, and provides assistance and compensation to workers in old age, illness, work injury, unemployment and maternity.

2. Employers and workers must participate in social insurance and pay social insurance premiums according to law.

Two. Types of social insurance:

1. Endowment insurance; 2. Unemployment insurance; 3. Medical insurance; 4. Work injury insurance; 5. Maternity insurance.

Third, the payment base:

Employers and workers jointly pay social insurance premiums, with 60%-300% (40%-300% in some places) of the average monthly salary of employees in the province where the workers are located as the payment base and paid monthly.

Four, the unit insurance types and payment ratio:

1. Endowment insurance premium: 20% paid by the unit and 8% paid by the individual.

2. Unemployment insurance premium: 2% paid by the unit and 1% paid by the individual.

3. Medical insurance premium: the unit pays 8% and the individual pays 2%.

4. Work-related injury insurance premium: paid by the unit, but not by the individual.

5. Maternity insurance premium: paid by the unit, but not by the individual.

Five, personal insurance coverage and payment ratio:

1. Old-age insurance premium: 20% paid by individuals.

2. Medical insurance premium: individuals pay 5%.

3. Maternity insurance premium: paid by individuals 1% (in some areas).

Six, two conditions for retirement to receive social security pension:

1. The actual payment period of the insured exceeds 10 years (1September 30th, 998 and before) or 15 years (1June, 998 10 and after);

2. The insured reaches the statutory retirement age.

Seven, the current statutory retirement age:

1. Female: the insured employee of the unit is 50 years old; The manager is 55 years old All insured individuals are 55 years old.

2. M: They are all 60 years old. Employees, managers, units and individuals all have insurance.

3. Among them, workers who are engaged in underground, high altitude, high temperature, particularly heavy manual labor or other jobs harmful to health, workers who work in plateau areas above 3,500 meters above sea level and low-temperature places such as cold storage and production workshops below zero degrees Celsius all the year round, can retire early (female employees are over 45 years old and male employees are over 55 years old).

Eight, three factors affecting the amount of pension:

1. When you retire, the salary in the province in the previous year (the salary in the province is increasing every year, and the pension is also increasing year by year. Therefore, the later the retirement time, the more pensions);

2. My payment period (the longer the payment period, the more the pension);

3. Personal account amount (the more contributions, the more pensions).

Nine, medical insurance benefits are divided into three:

1. Medical insurance for general diseases:

A. outpatient expenses cannot be reimbursed.

B. About 80% of hospitalization expenses will be reimbursed, and about 20% will be borne by individuals. The maximum reimbursement amount is tens of thousands of yuan.

2. Chronic disease outpatient medical insurance: outpatient expenses can be reimbursed, and the reimbursement ratio is the same as above.

3. Hospitalization medical insurance for serious illness: the reimbursement ratio of hospitalization expenses is the same as above. The maximum reimbursement amount100000 yuan or more.

X. Other insurance benefits:

1. unemployment insurance benefits: Unemployed persons who have paid unemployment insurance premiums for 1 year, have suspended their employment due to their own wishes, have registered for unemployment and have job requirements can receive unemployment insurance benefits; While enjoying other unemployment insurance benefits.

2. Work-related injury insurance benefits: employees who suffer from accidents at work, including motor vehicle accidents on their way to and from work, enjoy medical treatment for work-related injuries; Disabled people enjoy disability treatment.

3. Maternity insurance benefits: the expenses of prenatal examination and production of female employees are reimbursed by social security in proportion; In the same period, the insured husband has a week's accompanying leave, and the holiday salary is paid by social security.

Xi。 Reservation, transfer, waiver and succession:

1. Reservation: Social insurance relationships caused by termination of insurance, joining the army, studying abroad, sentencing, etc. shall be reserved. After that, the insurance can be renewed, and the individual payment period and payment amount are calculated cumulatively.

2. Transfer: you can transfer to the unit in the same city or transfer to individual payment; Need to transfer, should be transferred to the local social security center for approval.

3. Surrender: Urban hukou cannot be surrendered. Migrant workers who have settled abroad and returned home can surrender their insurance.

4. Inheritance: If the insured person dies before retirement, the personal account amount of endowment insurance and medical insurance shall be inherited by the legal heir.

For details, please contact the labor security telephone number 12333.