The difference between employee medical insurance and resident medical insurance

The difference between residents' medical insurance and employees' medical insurance lies in:

1, the object of participating in residents' medical insurance is the residents who have no jobs; Employees' medical insurance targets are work units or flexible employees;

2. Residents' medical insurance is paid by individuals; Medical insurance for employees shall be jointly paid by units and individuals;

3. Residents' medical insurance benefits are lower than employees' medical insurance.

Employees' medical insurance is paid once a month and residents' medical insurance is paid once a year; Accumulated, employee medical insurance will pay more every year. Secondly, enjoy different treatment. Employees pay more for medical insurance and enjoy higher treatment than residents' medical insurance. For example, if the reimbursement rate is higher, you can use your personal account to see a doctor in an outpatient clinic and buy medicine in a pharmacy. Finally, employees' medical insurance can enjoy retirement exemption after paying the prescribed number of years. There is no exemption for residents' medical insurance, and they must pay on time every year to enjoy the treatment.

legal ground

People's Republic of China (PRC) Social Insurance Law Article 25 The State establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government. Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state. Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits. Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) borne by public health;

(4) Go abroad for medical treatment. Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.