The difference between the first, second and third grades of social security in Shenzhen

The medical insurance for employees of enterprises in Shenzhen is divided into three grades: basic medical care level 1, basic medical care level 2 and basic medical care level 3, with different payment, treatment and adaptation groups. The differences are as follows:

I. Payment

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 13 1 yuan), with a total payment of 272 yuan;

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

3. The third basic medical care (unit 0.4%+ individual 0. 1%)+ 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;

Two. deal with

1. In terms of outpatient service, there is an annual outpatient fee of 1000 yuan for Grade III and II basic medical care, but it can only be enjoyed if it is bound to a community health hospital. Primary medical service All hospitals can see out-patients, but they all use money from personal accounts. When there is no money in personal accounts, they have to withdraw cash by themselves. To put it bluntly, you paid for all the money. You can report 1000 yuan per year for the second and third levels of basic medical care, which is the money from the overall planning fund, while the money from the first-level outpatient service of basic medical care is your own money, and only the money from the overall planning fund can be truly reimbursed. Of course, the first file of basic medical care does not mean that there is no welfare. It has the following three advantages: first, it has been insured continuously for more than 12 months, and the out-of-pocket expenses of outpatient service exceed 3 1 and 3 1 yuan in a medical year, and the excess part can be reimbursed by 70%; Second, it can be reimbursed in all social health hospitals; Third, the number of outpatients is large.

2. In terms of hospitalization,

The primary and secondary treatment of basic medical care is the same, with a unified report of 90%. All designated hospitals in Shenzhen can directly handle hospitalization, and the reimbursement rate is 90%;

According to different levels of hospitals, the proportion of reimbursement for tertiary hospitalization in basic medical care can be 85% in first-class hospitals, 80% in second-class hospitals and 75% in third-class hospitals.

legal ground

People's Republic of China (PRC) social insurance law

Article 4 The State establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance. Safeguard citizens' right to get material help from the state and society in accordance with the law in old age, illness, work injury, unemployment and childbirth.

Article 3 The social insurance system adheres to the principles of wide coverage, basic protection, multi-level and sustainability, and the level of social insurance should be compatible with the level of economic and social development.

Article 58 An employing unit shall, within 30 days from the date of employment, apply to the social insurance agency for social insurance registration for its employees. If the social insurance has not been registered, the social insurance agency shall verify the social insurance premium it should pay.

Employees-free individual industrial and commercial households who voluntarily participate in social insurance, part-time employees who do not participate in social insurance in the employing unit and other flexible employees shall apply to the social insurance agency for social insurance registration.

The state establishes a national unified personal social security number. Personal social security number is a citizen's identity number.