Social Security First, Second and Third Details

It's different to enjoy medical treatment. The following details are introduced:

(1) principle of seeking medical treatment

First-class insured: any designated medical institution in this city for medical treatment.

Second-class insured persons: outpatients seek medical treatment in the binding community health center, inpatient departments seek medical treatment in any designated medical institutions in the city, and outpatients seek medical treatment in designated medical institutions for serious illness.

Third-level insured persons: outpatients seek medical treatment in the binding social health center, and inpatients and outpatients seek medical treatment in prescribed medical institutions for serious illness.

(2) General outpatient treatment

A type of insurance: personal account is used to pay the medical expenses within the scope of the insured's general outpatient medical insurance catalogue. Community health center basic medical expenses personal account to pay 70%, the overall fund to pay 30% in accordance with the provisions.

Second Insured/Third Insured:

Belong to class A drugs and class B drugs, respectively, by the community outpatient fund according to the proportion of 80% and 60% payment; 90% of the single diagnosis and treatment or medical materials belonging to the medical insurance catalogue shall be paid by the community outpatient co-ordination fund, but the maximum payment amount shall not exceed 120 yuan; The total outpatient medical expenses paid by the community outpatient co-ordination fund to each second-grade and third-grade insured within a medical insurance year shall not exceed 1000 yuan.

(3) Hospitalization

First-class insured: 95% or 90% of the basic medical expenses incurred in hospitalization and supplementary medical expenses above the deductible line shall be paid according to the regulations.

Second-level insured/third-level insured: you can be hospitalized in the settlement hospital bound to the social rehabilitation center, or you can be referred to the designated hospital through the settlement hospital. The reimbursement rates of basic medical expenses and local supplementary medical expenses above the hospitalization deductible line are: 85% for first-class hospitals, 80% for second-class hospitals and 75% for third-class hospitals.

The difference between the first grade and the second grade of social security is that the social security payment grade is divided into four grades: the lowest grade (40%), the first grade (60%), the second grade (80%) and the third grade (100%). The first file is paid according to 60% of the average wage payment base of last year, and the second file is paid according to 80% of the average wage payment base of last year. The higher the level, the more you get.

Legal basis:

"People's Republic of China (PRC) Social Insurance Law" Article 74 The social insurance agency shall obtain the information needed for social insurance work through business handling, statistics and investigation, and the relevant units and individuals shall provide it in a timely and truthful manner. The social insurance agency shall establish a file for the employer in a timely manner, completely and accurately record the social insurance data such as personnel's participation in social insurance and payment, and properly keep the original vouchers for registration and declaration and accounting vouchers for payment and settlement. The social insurance agency shall timely, completely and accurately record the individual's contributions to social insurance, the employer's contributions and the enjoyment of social insurance benefits and other personal rights and interests records, and regularly send the personal rights and interests records to me free of charge. Employers and individuals can inquire and check the records of payment and social insurance benefits from social insurance agencies free of charge, and ask social insurance agencies to provide social insurance consultation and other related services.