Job Recruitment Website - Social security inquiry - What is the difference between social security medical insurance and urban medical insurance?
What is the difference between social security medical insurance and urban medical insurance?
1, the scope of enjoyment is different: employees' medical insurance can't enjoy the reimbursement of hospitalization maternity medical care; Employees with serious chronic diseases (serious diseases) enjoy 17 diseases, and residents enjoy 8 diseases;
2. Different reimbursement rates: First, different reimbursement rates for hospitalization. The reimbursement rate of employees in medical insurance is 92% for Class A and 70-80% for Class B; The reimbursement rate of retired workers in hospital is 92% for Class A and 70-80% for Class B. The reimbursement rate of residents in medical insurance is 80% and 70% for first-class hospitals, 70% and 60% for second-class hospitals and 60% and 50% for second-class hospitals. Second, the proportion of reimbursement for outpatient services with serious chronic diseases (serious illness) is different: the proportion of reimbursement for medical insurance for employees is 75%, and that for residents is 50%;
3. The maximum payment limit of pooling funds and large medical insurance is different. The maximum payment limit of the basic medical insurance fund for employees is 4 times of the average salary of employees in the previous year in this district, and the maximum payment limit of large medical insurance is 300,000 yuan; The maximum payment limit of urban residents' basic medical insurance co-ordination fund is 4 times of the annual disposable income of residents in this area, and the maximum payment limit of large medical insurance is 80 thousand yuan.
The materials required to pay social security are as follows:
1, social insurance registration form, on-the-job employee change roster, and on-the-job employee basic information registration form;
2. Copy of business license (or approval document);
3. A copy of the local tax registration certificate;
4. Copy of organization code certificate;
5. The recent salary roster of the insured unit;
6. Copy of the insured's ID card, and migrant workers are required to provide a copy of the household registration book;
7, the first time to participate in medical insurance personnel to provide a one-inch red background photo.
The social security card has the following functions:
1, personal social security related information records, electronic certificates and information inquiry, etc. ;
2. Record the insured's name, ID number, date of birth, gender, nationality, household registration and other basic information;
3, query my pension, unemployment, medical care, work injury and maternity insurance payment;
4. You can take the card to the hospital to see a doctor, settle the medical insurance personal account, and buy medicine at the pharmacy;
5 for medical care, unemployment, pension, work injury, maternity and other social security affairs;
6. Query the total amount of endowment insurance and medical insurance;
7. Handle social security affairs such as receiving pensions, registering for job hunting and unemployment, applying for unemployment insurance benefits, and vocational training.
To sum up, the maximum payment limit of pooling funds and large medical insurance is different. The maximum payment limit of the basic medical insurance fund for employees is 4 times of the average salary of employees in the previous year in this district, and the maximum payment limit of large medical insurance is 300,000 yuan; The maximum payment limit of urban residents' basic medical insurance co-ordination fund is 4 times of the annual disposable income of residents in this area, and the maximum payment limit of large medical insurance is 80 thousand yuan.
Legal basis:
Article 2 of People's Republic of China (PRC) Social Insurance Law
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 12
The employing unit shall pay the basic old-age insurance premium according to the proportion of the total wages of its employees stipulated by the state, and record it in the basic old-age insurance pooling fund. Employees shall pay the basic old-age insurance premium in accordance with the proportion of wages stipulated by the state and record it in their personal accounts.
Article 23
Employees should participate in the basic medical insurance for employees, and employers and employees should jointly pay the basic medical insurance premiums in accordance with state regulations.
Article 33
Employees shall participate in work-related injury insurance, and the employer shall pay the work-related injury insurance premium, and the employees shall not pay the work-related injury insurance premium.
Article 44
Employees should participate in unemployment insurance, and employers and employees should jointly pay unemployment insurance premiums in accordance with state regulations.
Article 53
Employees shall participate in maternity insurance, and the employer shall pay maternity insurance premiums in accordance with state regulations, and employees shall not pay maternity insurance premiums.
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