What is the proportion of social security and medical insurance payment in Shenzhen?

Medical insurance is divided into three grades: basic medical care level 1, basic medical care level 2 and basic medical care level 3, and their payment and treatment are different. Different regions have different policies. Take Shenzhen as an example:

First, pay the fee.

(1) basic medical care: (unit 6%+ individual 2%)+ local supplementary medical care (unit 0.2%)+ maternity medical care (unit 0.5%), and the payment base is the actual payment salary of employees (minimum 3 1, 3 1 yuan), with a total payment of 272 yuan;

(2) The second basic medical care: (unit 0.5%+ individual 0.2%)+ local supplementary medical care (unit 0. 1%)+ maternity medical care (unit 0.2%) The payment base is the average monthly salary of employees in the previous year (now 52 18), and the accumulated payment is 52;

(3) The third stage of basic medical care: (unit 0.4%+0.65438+ individual 0%)+ local supplementary medical care (unit 0.05%). The payment base is the average monthly salary of employees in the previous year (now 52 18), and the total payment is 29 yuan.

Second, treatment.

(1) hospitalization. The first-level basic medical care and the second-level basic medical care are the same, and the unified report is 90%. The proportion of reimbursement for tertiary hospitalization in basic medical care depends on the level of the hospital.

(2) outpatient service. There is an annual outpatient fee of 1000 yuan for the third and second levels of basic medical care, but it should be used in specific hospitals.

legal ground

"People's Republic of China (PRC) social insurance law" thirtieth the following medical expenses are not included in the scope of payment of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.