Job Recruitment Website - Social security inquiry - If you don't pay medical insurance for a few months, it will be broken.
If you don't pay medical insurance for a few months, it will be broken.
First, employees who have stopped paying for medical insurance within 3 months (excluding 3 months) are not considered to have stopped participating in the insurance, and those who have stopped paying for 3 months (including) are considered to have stopped participating in the insurance, and they will enjoy medical insurance benefits from the next month after the payment is interrupted. After going through the normal payment procedures, they will enjoy medical insurance benefits from the next month; After the interruption of insurance, you can apply for insurance procedures and pay for 6 months in a row before you can enjoy medical insurance benefits.
Two, the basic medical insurance fund for employees and individual accounts shall be accounted for separately according to their respective scope of payment, and shall not be crowded with each other.
(1) Personal account, which is used to pay out-patient expenses, out-of-pocket expenses of hospitalization and shopping expenses of designated pharmacies.
(2) the overall fund is used to pay for hospitalization and some outpatient serious illness expenses. The overall fund payment has a minimum payment standard and a maximum payment limit. Qifubiaozhun is controlled in principle at about 10% of the average annual salary of local employees, and the maximum payment limit is controlled in principle at about 4 times of the average annual salary of local employees. Medical expenses below Qifubiaozhun shall be paid by personal account or borne by individuals. Medical expenses above Qifubiaozhun and below the maximum payment limit are mainly paid by the overall fund.
Third, how to apply for medical insurance?
Generally speaking, medical insurance is handled centrally by the unit where employees work, but people without work units can also apply for medical insurance themselves or buy suitable commercial medical insurance.
According to China's medical insurance regulations, anyone who meets the requirements can apply for personal medical insurance, but the medical insurance application process of different people is different, and some corresponding documents and materials need to be provided.
If it is handled by an individual, a complete personnel file is required, and the individual can bring his own file to the local social security center for handling.
If the unit where the individual worked before has already applied for personal medical insurance, you only need to issue a certificate to prove that the labor relationship has been terminated, and then you can go to the social security center with the relevant insurance materials.
It should be noted that individuals must carry their ID cards and then open accounts at designated banks as required. After opening an account, they should tell the social security center the card number. There is no charge when handling, and the amount of medical insurance payment is completely determined by the individual.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 27 If an individual who participates in the basic medical insurance for employees reaches the statutory retirement age and the accumulated payment reaches the fixed number of years stipulated by the state, he will no longer pay the basic medical insurance premium after retirement, and if he enjoys the basic medical insurance benefits according to the provisions of the state but has not reached the fixed number of years stipulated by the state, he can pay the fee to the fixed number of years stipulated by the state. There are two special situations in which employees' medical insurance can pay:
1. If the employee's medical insurance is paid off due to the unit, the employee can pay it back through the unit.
2, in the case of retirees medical insurance payment period is insufficient, you can also apply for payment.
Twenty-third employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
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