Difference between Shenzhen Comprehensive Social Security and General Insurance

There are three kinds of medical insurance for social security: comprehensive medical care, hospitalization medical care and labor medical care.

1. Comprehensive medical insurance: both deep households and non-deep households can participate. Pay more, Shenzhen hukou must participate in comprehensive medical insurance. You can buy medicines in pharmacies, see outpatient clinics, stay in hospitals, enjoy reimbursement for serious illness outpatient clinics, and enjoy maternity insurance. Foreign urban hukou can also buy comprehensive medical insurance, as long as the work unit is willing.

2. Hospitalization medical insurance: Foreign urban hukou must participate in hospitalization medical insurance, and the payment is less than comprehensive medical insurance. Can enjoy a small amount of outpatient reimbursement, maternity insurance benefits, foreign farmers and units are willing to participate in this hospitalization medical insurance, mainly for non-Shenzhen hukou payment. Hospitalization can reimburse most of the expenses, excluding maternity insurance. You can see the clinic, but you need to go to the bound community health center.

3. Migrant workers' medical insurance (commonly known as migrant workers' medical insurance, also known as cooperative medical insurance): This is for foreign farmers, and the hospitalization treatment is relatively low, with a small amount of outpatient subsidies and hospitalization reimbursement, but the reimbursement ratio and limit are not as high as the above two medical insurances, and there are not as many hospitals as above. Need to go to the bound social health clinic, excluding maternity insurance. Non-local farmers and units should at least provide medical insurance for workers. If the unit is willing, it can choose hospitalization medical insurance. At least all non-local urban hukou should be inpatient medical insurance. If the unit is willing, it can participate in comprehensive medical insurance.

The above three kinds of medical insurance hospitalization can be reimbursed, and hospitalization reimbursement is the same as hospitalization, but the reimbursement treatment of cooperative hospitalization is lower than the first two kinds, and the choice of hospitals is not more than the first two kinds. You can only go to the designated social health hospital for medical treatment, not directly to the big hospital.

The reimbursement rate of migrant workers' medical insurance is not as high as that of urban medical insurance. The reimbursement ratio of medical insurance for urban workers and urban residents is different. Generally speaking, medical insurance for employees is higher than that for residents, with an average of 80% for employees and 50% for residents. As for the specific proportion, it is related to the age of the insured and the level of the hospital. The older you are, the lower the hospital level and the higher the reimbursement rate. (The term "migrant workers" as mentioned in these Measures refers to non-urban household registration employees who are employed in this Municipality and are not registered in this Municipality. )

The monthly fee is different:

1. Comprehensive medical insurance: individuals pay 2%, the minimum base is 2 173 yuan (calculated by 362 1 yuan *60%), and 43.46 yuan is deducted from the salary every month. The unit pays 5% (comprehensive insurance+local supplement+maternity insurance), namely 108.65 yuan. Individual and unit contributions 152. 1 1 yuan/month. Comprehensive medical insurance is the most comprehensive, including outpatient, inpatient and maternity insurance. You can choose a designated medical institution for medical treatment. Monthly payment is much more than hospitalization and cooperative medical care.

2. Hospitalization medical insurance: the individual pays 0.2%, with the base of 2 173 yuan, and 4.346 yuan is deducted from the salary every month. The unit pays 0.7%, namely 15.5438+0 1 yuan. Individual and unit payment 19.557 yuan/month. Serious illness and hospitalization are the same as comprehensive treatment. You need to go to the bound social welfare clinic to see the clinic. The annual outpatient fee is capped at 800.

Note: the payment of comprehensive medical insurance is based on the total monthly salary of employees, but it shall not be higher than 300% or lower than 60% of the average monthly salary of employees in the previous year. Higher or lower, respectively, with 300% or 60% as the base. Since July 1 day, 2009, the average monthly salary of employees in our city's social insurance payment base and treatment scheme in the previous year was calculated to be 362 1 yuan, and the minimum payment base of pension insurance for registered employees in Shenzhen was 2 173 yuan (that is, 362 1X60%).

3. Cooperative medical care (commonly known as migrant workers' medical insurance, now renamed migrant workers' medical insurance): individuals pay 4 yuan, work 8 yuan, and need to go to Binshekang to see a doctor.