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What are the procedures for paying enterprise medical insurance?
Legal analysis: Go to the local medical insurance center and bring the list, ID card, photos, labor contract, social security, salary manual, personnel increase and decrease table, etc. Note: those who apply for medical insurance must apply for social security first. How to handle medical insurance and social security is like this. There are two ways to apply for and renew social security: (-) If an individual pays in his own name, he/she needs to apply to the social security bureau where his/her household registration is located. The insurance procedures include: his/her ID card, two recent one-inch bareheaded photos, insurance premium, application form, etc. And can only apply for pension and medical insurance. How much to pay is calculated according to the local social wage of the previous year, which is different every year. For example, the average salary of a prefecture-level city is 20,000, then the pension insurance payment is 20,000 * 20% = about 4,000/year, and the medical care is 20,000 *10% = about 2,000/year. In addition, it is also stipulated that the lowest grade and the highest grade are not less than 60% of the average monthly salary of social workers, and the highest grade is 300% of the average monthly salary of employees. Generally, the lowest grades are mostly. In addition, the minimum payment period of old-age insurance is 180 months, that is, 15 years, and medical insurance needs to pay at least 25/30 years. When you reach retirement age, you can apply for pension benefits and medical reimbursement (as long as you renew your fees, you can usually). (two) or to purchase or renew social security. It is a foreign hukou, and social security can only be purchased through the unit. In addition, if we apply for social security, it is better for the second unit to pay it, because the unit will bear a large part of the expenses for us, thus reducing the pressure on our own payment. For medical reimbursement: it is best to seek medical treatment at the place of purchase, and it is not supported to seek medical treatment in different places. Therefore, it is necessary to obtain the approval of the local medical management institution before seeking medical treatment. Rural cooperative medical insurance is purchased in the same year, takes effect in the following year, and can enjoy reimbursement treatment. The reimbursement of cooperative medical insurance needs to be handled at the medical insurance checkout window of the local cooperative medical management institution or designated medical institution. Procedures include: my ID card, medical insurance card, original invoice, medication list, medical records and other materials. The reimbursement of cooperative medical insurance is carried out in proportion, generally fluctuating around 20-85%. The proportion and amount of reimbursement are related to their own examination and medication, medical level and other factors. For example, it is clear that Class A drugs can enjoy full coverage, Class C drugs need to bear all the costs, and Class B drugs will report 80% and bear 20% of the costs. Someone spent a total of 19000 yuan on medical expenses, and the reimbursement formula is as follows: (19000-500 "deductible"-self-paid medicine) *70%. If self-funded drugs account for a large proportion, there is not much amount to be reimbursed.
Legal basis: Article 2 of the Social Insurance Law of People's Republic of China (PRC) The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance, etc., to protect citizens' right to get material help from the state and society according to law in case of old age, illness, industrial injury, unemployment and maternity.
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