What is the difference between the reimbursement ratio of the first and second class of medical insurance?

1. The reimbursement ratio is different

For those who pay the first grade of medical insurance, the maximum reimbursement ratio of the first grade of social security for the first level of hospitalization can reach 85%, while the reimbursement ratio of the second grade of medical insurance is only 80%. Later on, and so on, the second and third hospitalization reimbursement rate will be 5% difference.

2. Different reimbursement limits

The first tier of social security has higher reimbursement limits. For some family accounts, the reimbursement limit for children's critical illnesses in the family account is also different, and each region will have specific limits, but generally in the upper and lower 25%.

3. Different contribution levels

As long as your social security is a first-tier social security, you will pay for first-tier health insurance. The cost of first-tier Medicare is a bit higher than second-tier social security, and there are also different amounts for each region.

4. Different principles of medical care

First-tier participants are any hospital in the city for medical care, second-tier participants have outpatient medical care at the bounded community health centers, inpatient medical care at any hospital in the city for medical care, and outpatient medical care at medical institutions for serious illnesses.

5. Applicable to different groups of people

Shopping for the first class of health insurance is generally well-known large companies, listed companies, etc.; the second class of health insurance is generally more for the type of business units.

Can I change my health insurance plan?

You can change it. But many places can only change the level of medical insurance once a year, when you change, you have to remember whether you want strong reimbursement or low expenses, once changed, can not be changed again within this year.

Overall, there is a difference between the first and second class health insurance in many aspects, naturally, no matter which class of health insurance you pay, you have to pay your health insurance on time, to prevent a break in payment.

Legal basis:

The People's Republic of China Social Insurance Law

Article 25: The State establishes and improves the basic medical insurance system for urban residents.

Basic medical insurance for urban residents is a combination of individual contributions and government subsidies.

The government shall subsidize the part of individual contributions required by those who are entitled to the minimum subsistence guarantee, persons with disabilities who have lost their ability to work, and elderly persons and minors over sixty years of age from low-income families.