The difference between the first, second and third levels of medical insurance.

The differences between primary, secondary and tertiary medical insurance are as follows:

1, the payment standard is different: for the first time insured, the individual pays 2% and the unit pays 6%; Class II insured individuals pay 0.2%, and units pay 0.6%.

2, the applicable population is different: the first file is suitable for deep households to buy, and non-deep households can also buy; The second grade is suitable for companies that pay the second grade medical insurance.

3. The principle of seeking medical treatment is different: the first type of insured person goes to any designated medical institution in the city for medical treatment; Class II insured persons are treated in the binding community health center, hospitalized in any designated medical institution in the city, and seriously ill in the prescribed medical institution.

4, hospitalization reimbursement is different: the first file, 90% hospitalization, need to be hospitalized in a designated hospital; The second file, 90% of hospitalization reports, requires hospitalization in designated hospitals.

5. Outpatient reimbursement is different: in the first file, the basic outpatient medical expenses and supplementary medical expenses paid by me in the same medical insurance year are 5% of the average salary of supermarket employees, and the excess part is paid by the overall fund according to regulations. The secondary insured has no specific time requirement.

Put forward the standard of medical insurance interruption:

1. Unpaid social insurance premium: If the insured fails to pay the social insurance premium according to the regulations or fails to pay the social insurance premium on time, it will be regarded as unpaid social insurance premium, which may lead to medical insurance failure;

2. Medical insurance fraud: If the insured person commits fraud when using the medical insurance card, such as falsely listing medical expenses, it will be considered as medical insurance fraud, which may lead to the suspension of medical insurance;

3. The medical insurance participation qualification does not meet the requirements: if the identity certificate, household registration and other relevant certification materials of the medical insurance insured do not meet the medical insurance participation conditions, it is deemed that the medical insurance participation qualification does not meet the requirements, which may lead to the suspension of medical insurance.

To sum up, you can participate in medical insurance and pay medical insurance fees on time, so that you can enjoy medical insurance when you go to see a doctor.

Legal basis:

Article 26 of People's Republic of China (PRC) Social Insurance Law

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Article 27

Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; 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.

Article 28

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.