Is the proportion of social security reimbursement related to hospitals?

The proportion of social security overall reimbursement has a certain relationship with the hospital.

Different levels of medical institutions have different reimbursement rates. The state encourages patients to go to primary hospitals for minor illnesses and to big hospitals for serious illnesses. In order to guide patients, the reimbursement rate of grass-roots hospitals is higher than that of large hospitals, and the deductible line of some local grass-roots hospitals is also set lower than that of large hospitals.

Under the same level of medical institutions, the reimbursement ratio of employee medical insurance and resident medical insurance is different. Due to the differences between employee medical insurance and urban and rural residents' medical insurance in terms of participation and financing, the annual per capita payment of employee medical insurance is several thousand yuan, while the annual per capita payment of urban and rural residents' medical insurance is only several hundred yuan, so the reimbursement treatment is different. In the case of the same level of medical institutions, the reimbursement ratio of employee medical insurance is higher than that of urban and rural residents' medical insurance.

Public hospitals and private hospitals have the same reimbursement rate on the premise of the same level. The proportion of social security overall reimbursement is related to the insurance level and insurance type of the hospital.

The conditions for purchasing social security are as follows:

1, age condition: female under 40 years old, male under 60 years old;

2. If a unit has paid five insurances and one gold, it is enough to submit the corresponding information for social security. Copy of ID card, electronic photo (paper photo with red background in some areas) or original ID card are required. Rural hukou also needs to provide a copy of the home page and my page;

3. If individuals want to apply for social security, they can only participate in pension and medical care, and local accounts can be handled directly at the local social security bureau. Not a long-term resident who needs to open relevant certificates for local accounts.

The condition for individuals to purchase social insurance is that they are 16 years old or above, have not reached retirement age, have not participated in the basic endowment insurance for urban enterprises, and can only purchase medical insurance and endowment insurance as individuals. The rest, such as maternity insurance, unemployment insurance and industrial injury insurance, must be paid in the name of the employer after the establishment of labor relations.

To sum up, social insurance refers to a social and economic system that provides income or compensation for people who have lost their ability to work, are temporarily unemployed or suffer losses due to health reasons. The main items of social insurance include endowment insurance, medical insurance, unemployment insurance, industrial injury insurance and maternity insurance.

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 receive material assistance 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 in People's Republic of China (PRC) pay social insurance premiums according to law, and have the right to inquire about payment records and personal rights records, and require social insurance agencies to provide social insurance consultation and other related services.

Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.

Article 5

The people's governments at or above the county level will incorporate social insurance into the national economic and social development plan.

The state raises social insurance funds through multiple channels. People's governments at or above the county level shall give necessary financial support to social insurance.

The state supports social insurance through preferential tax policies.