How many files does Shenzhen social security have in 20 18?

Let me give you a complete one. Shenzhen medical insurance is divided into first, second and third grades.

The difference between the two mainly lies in the payment and the treatment that can be enjoyed. If it is a deep household employee, the employer must participate in the first-grade medical insurance for it, and the grade cannot be changed. If it is a non-registered employee, the employer can choose one of the first, second and third grades of medical insurance, and the same company has an opportunity to change the basic medical insurance grade for its employees once a year.

Different payment standards

From July, 2065438 1 day to June, 30, 2065438 +09, if the base of social security payment and treatment calculation in Shenzhen involves the average monthly salary of employees in Shenzhen last year, it will be calculated according to the standard of 8348 yuan/month.

first gear

Employees who participate in the first medical insurance shall pay monthly according to the standard of 8% of their total monthly salary, of which 6.2% shall be paid by the employer and 2% by the individual.

If my total monthly salary exceeds 300% of the average monthly salary of employees in this Municipality last year, I will pay it according to 300% of the average monthly salary of employees in this Municipality last year;

If the total monthly salary is lower than 60% of the average monthly salary of employees in this Municipality last year, it shall be paid according to 60% of the average monthly salary of employees in this Municipality last year.

Therefore, the maximum down payment base for medical insurance is 25,044 yuan (8,348 yuan X300%) and the minimum is 5,009 yuan (8,348 yuan X60%).

According to the proportion of payment, the upper limit of monthly payment is 1552.73 yuan, and the lower limit is 3 10.56 yuan; The upper limit of individual monthly payment is 500.88 yuan, and the lower limit is 100. 18 yuan.

second gear

The second payment base of medical insurance is the average monthly salary of employees in Shenzhen last year, which is currently 8,348 yuan, and the payment ratio is 0.8% (basic medical insurance+local supplementary medical insurance), of which the unit pays 0.6% and the individual pays 0.2%. According to the payment ratio, the unit pays 50.08 yuan per month and the individual pays 16.7 yuan per month.

third gear

The payment base of the third medical insurance is the average monthly salary of employees in Shenzhen last year, which is currently 8,348 yuan, and the payment ratio is 0.55% (basic medical insurance+local supplementary medical insurance), of which the unit payment is 0.45% and the individual payment is 0. 1%. According to the payment ratio, the unit pays 37.56 yuan per month and the individual pays 8.35 yuan per month.

Principle of seeking medical treatment

First-class insured: any designated medical institution in this city for medical treatment.

Second-class insured persons: outpatients seek medical treatment in the binding community health center, inpatient departments seek medical treatment in any designated medical institutions in the city, and outpatients seek medical treatment in designated medical institutions for serious illness.

Third-level insured persons: outpatients seek medical treatment in the binding social health center, and inpatients and outpatients seek medical treatment in prescribed medical institutions for serious illness.

General outpatient treatment

A type of insurance: personal account is used to pay the medical expenses within the scope of the insured's general outpatient medical insurance catalogue. Community health center basic medical expenses personal account to pay 70%, the overall fund to pay 30% in accordance with the provisions.

Second Insured/Third Insured:

Belong to class A drugs and class B drugs, respectively, by the community outpatient fund according to the proportion of 80% and 60% payment;

90% of the single diagnosis and treatment or medical materials belonging to the medical insurance catalogue shall be paid by the community outpatient co-ordination fund, but the maximum payment amount shall not exceed 120 yuan;

The total outpatient medical expenses paid by the community outpatient co-ordination fund to each second-grade and third-grade insured within a medical insurance year shall not exceed 1000 yuan.

Personal account family welfare

First-class insured:

If the accumulated amount of personal account exceeds 5% of the average wage of employees in this Municipality last year, the excess can be purchased from designated pharmacies within the scope of medical insurance catalogue;

When visiting a designated medical institution, you can pay the basic medical expenses and local supplementary medical expenses paid by yourself and your spouse and immediate family members who participate in the basic medical insurance in this Municipality;

It can cover the health check-up and vaccination expenses for me, my spouse and immediate family members to participate in the basic medical insurance in this city.

Secondary Insured/Tertiary Insured: None. You can't swipe your social security card when you go to the drugstore to buy medicine.

Personal account is not enough to pay.

First-class insured:

If the first insured person has been insured for one year in a row, the average salary of supermarket employees is 5% of the basic outpatient medical expenses and supplementary medical expenses paid by himself in the same medical insurance year, and 70% (80% for those over 70 years old) is paid by the overall fund in accordance with the regulations.

Secondary Insured/Tertiary Insured: None.

Large-scale outpatient equipment inspection and treatment costs

First-class insured: 80% shall be paid by the overall fund as required.

Second-level insured/third-level insured: the highest unit price of general medical treatment items shall not exceed 120 yuan.

Blood transfusion cost in general outpatient department

First-class insured: 90% shall be paid by the overall fund as required.

Second-level insured/third-level insured: 70% shall be paid by the overall fund as required.

Treatment of serious illness in outpatient department

First-class insured/second-class insured/third-class insured: 60%-90% will be paid by the overall fund according to the continuous insurance years.

be hospitalized

First-class insured: 95% or 90% of the basic medical expenses incurred in hospitalization and supplementary medical expenses above the deductible line shall be paid according to the regulations.

Second Insured/Third Insured:

1, you can be hospitalized in the settlement hospital of the binding social health center, or you can be referred to the prescribed hospital by the settlement hospital. The reimbursement ratio of basic medical expenses and local supplementary medical expenses above the hospitalization deductible line is:

Level I hospital: 85%

Level II hospital: 80%

Tertiary hospitals: 75%

2. If you go to a hospital other than the settlement hospital without referral, you will be paid 90% of the hospitalization payment standard of this hospital (that is, the payment standard in the above 1).

Medical treatment outside the city

First-class insured: general outpatient expenses, serious illness outpatient expenses and hospitalization expenses can be reimbursed according to regulations.

Second-class insured/third-class insured: general outpatient expenses will not be reimbursed; In accordance with the provisions of the serious illness outpatient expenses and hospitalization expenses can be reimbursed according to the provisions.