Is the reimbursement ratio of employee medical insurance and new rural cooperative medical system the same?

Employee medical insurance is different from the new rural cooperative medical system in coverage and reimbursement ratio. Employee medical insurance will be superior to the new rural cooperative medical system in reimbursement. Only one of them can be reimbursed at the same time, but not at the same time. It is more cost-effective to choose employee medical insurance reimbursement, subject to local medical insurance policies and rules, and analyze the specific situation.

Generally, the reimbursement rate of the new rural cooperative medical system is between 50% and 60%, and the reimbursement rate of employee medical insurance can be as high as 90%, but the deductible line of employee medical insurance is higher than that of the new rural cooperative medical system.

Reasons for the difference in reimbursement ratio between new rural cooperative medical system and employee medical insurance

1. Economic level

The level of economic development in rural areas is relatively low, and the income of the insured population is generally low, so the reimbursement rate of the new rural cooperative medical system is relatively low. The income of employees in cities is relatively high, and the insurance fees paid by enterprises for employees are correspondingly high, so the reimbursement ratio of employees' medical insurance is relatively high.

2. Medical resources

Urban medical resources are relatively rich and the quality of medical services is relatively high, so the proportion of medical insurance reimbursement for employees is relatively high. Medical resources in rural areas are relatively scarce and the quality of medical services is relatively low, so the reimbursement rate of the new rural cooperative medical system is relatively low.

3. Policy orientation

The government's investment in social security is also an important factor affecting the difference in reimbursement ratio between the two. The government's investment in urban social security is relatively high, so the proportion of medical insurance reimbursement for employees is relatively high. In rural areas, the government's social security investment is relatively low, so the reimbursement ratio of the new rural cooperative medical system is relatively low.

I hope the above content can help you. If in doubt, please consult a professional lawyer.

Legal basis:

Article 25 of the Social Insurance Law

The state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Article 26

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.