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How to change medical insurance for urban residents into social endowment insurance?
1. Employee basic medical insurance treatment standard: employee basic medical insurance pooling fund and individual account shall be accounted for separately according to their respective payment scope, and shall not be occupied.
(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.
2. Treatment standard of basic medical insurance for urban residents: The basic medical insurance for urban residents only establishes a pooling fund, not a personal account, and the fund is mainly used for hospitalization and some outpatient serious illness expenses. The proportion of fund payment is lower than the basic medical insurance for employees in principle, but higher than the new rural cooperative medical system, which can generally reach about 50% to 60%.
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