Job Recruitment Website - Social security inquiry - Will Shenzhen pay social security 15 years and continue to pay medical insurance?
Will Shenzhen pay social security 15 years and continue to pay medical insurance?
Dear hello, Shenzhen social security has been paid 15, so don't continue to pay medical insurance. First, the scope of medical insurance reimbursement Not all expenses can be reimbursed by medical insurance. To understand the proportion of medical insurance reimbursement, we must first understand the scope of medical insurance reimbursement 1. Deductible line and deductible line: outpatient or hospitalization expenses can only be reimbursed by medical insurance after reaching a certain amount. The threshold of outpatient and inpatient expenses is different, so is each region, and even different hospitals in the same region. Cap line: the upper limit of reimbursement for outpatient or inpatient expenses is the cap line. There are also differences in hospitals of different levels in different regions of the capping line. 2. Self-payment and self-payment: the part that cannot be reimbursed in the medical insurance catalogue. At one's own expense: all expenses outside the medical insurance catalogue, such as imported drugs and targeted drugs, are also included in the deductible line. 3. Medical insurance reimbursement Part of medical insurance can only reimburse outpatient and inpatient medical expenses in the medical insurance catalogue. There are three medical insurance catalogues, namely, the catalogue of medicines, the catalogue of diagnosis and treatment items and the catalogue of medical service facilities. Last year, the state revised the drug list and expanded the scope of reimbursement. The reimbursement ratio of outpatient expenses and hospitalization expenses is different. Take Beijing as an example: 1. The following is the reimbursement ratio of outpatient expenses in Beijing, including hospital type, deductible line and reimbursement ratio. Note: In Beijing, the outpatient service of on-the-job workers needs more than 1.800 yuan to be reimbursed. The community hospital in this city is the first choice for medical treatment, and the reimbursement rate is higher than that of non-community hospitals, rather than deliberately going to large hospitals. For example, Zhang San has reached the deductible line before, and the outpatient fee is 3,000 yuan, of which the self-funded part is 800 yuan and the self-funded part is 1 0,000 yuan, so the medical insurance reimbursement amount is: (3000-800- 1 0,000) × 90% =10,080 yuan, Zhang San. Zhang San's hospitalization (in a tertiary hospital) cost 20,000 yuan, including 8,000 yuan at his own expense and 5,000 yuan at his own expense, so the medical insurance reimbursement amount is: (20,000-1300-8,000-5,000) × 85% = 5,700 yuan, and Zhang San still needs to pay1400.
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