The Difference between the First and Second Social Security of Chongqing Residents

The difference between the first and second grade of Chongqing residents' medical insurance

First, the payment standards are different.

In 2023, the individual payment standard for residents' medical insurance is: 350 yuan for the first grade and 725 yuan for the second grade.

College students in Chongqing participated in residents' medical insurance during the school year from September 2022 to August 2023, and the personal payment standard was 695 yuan/person/year for the first grade 320 yuan and the second grade.

Second, the reimbursement ratio is different.

Outpatient reimbursement:

(1) Outpatient reimbursement rate: 60% for first-class medical institutions, 40% for second-class medical institutions, and no reimbursement for third-class medical institutions.

(2) Annual reimbursement limit: 300 yuan, the first-class insured; 500 yuan, insured for the second time.

(3) deductible standard: there is no deductible standard for first-class and below medical institutions, and it is not reimbursed for second-class medical institutions in 200 yuan and third-class medical institutions.

Hospitalization reimbursement:

Basic medical insurance medical insurance hospitalization reimbursement standard:

From June 5438+1 October1in 2023, the deductible line of serious illness insurance was adjusted to 1690 1 yuan/person/year. (The following reimbursement rate is in 2022, which was not announced in 2023. )

Residents' medical insurance A insured person's hospitalization policy within the scope of the cost is higher than the basic medical insurance Qifubiaozhun to the part below the payment limit, which shall be paid by the overall fund according to the following proportion:

Increase the reimbursement rate of class I insured in tertiary medical institutions to 50% (original 40%); The reimbursement rate of secondary medical institutions has increased to 70% (originally 65%).

The reimbursement rate of second-class insured personnel in secondary medical institutions has increased to 75% (from 72%); The reimbursement rate of tertiary medical institutions has increased to 55% (originally 50%).

Minors will increase by 5 percentage points on the above basis.

If the insured person's out-of-pocket expenses that meet the reimbursement scope of serious illness insurance for urban and rural residents in our city exceed the Qifubiaozhun for the first time or cumulatively within a natural year, the serious illness insurance will be paid in proportion.

Out-of-pocket expenses refer to the medical expenses incurred by the insured in the hospitalization and outpatient service of major diseases in special diseases, which belong to the scope of reimbursement by the residents' medical insurance fund and are paid by the insured after the initial reimbursement by the residents' medical insurance fund according to regulations.

Original policy: click to view.