How much is a personal account for Shenzhen medical insurance every month?

First, Shenzhen's first-class medical insurance

There is a balance every month,

There are differences according to age and payment.

The minimum on-the-job is 388.9 yuan, and the retirees are 626 yuan.

First, understand the policy. In July 2022, Shenzhen raised the average social wage to 12964 yuan. The amount of medical insurance is closely related to social wages.

What is the monthly amount of the second, first, second and third-level medical insurance?

(1) The first social security has a personal account, and the balance is recorded every month.

(2) Secondary and tertiary medical insurance, only pooling accounts, no monthly balance;

How much does it cost for a medical insurance file to enter a personal account?

(1) Payment proportion of individuals and units in the first, second and third stalls:

First gear: 637.80 yuan;

Second gear: 103+0 yuan;

Third gear: 7 1.30 yuan;

(2) The first monthly income is at least 388.9 yuan, which varies according to different age groups.

Three, enterprises to provide social security for urban workers:

Insured persons under the age of 45, 5% per month into personal accounts; The lowest is 7778*5%=388.9 yuan;

The insured is over 45 years old, which is included in the insured's monthly account of 5.6%; The lowest is 7778*5.6%=435.6 yuan.

The minimum payment base of the first-class medical insurance for deep-seated flexible employees is 5 186 yuan, which is only included in the personal medical insurance account:

Under 45 years old: 5 186*5%=259.3 yuan;

Over 45 years old: 5 186*5.6%=290.4 yuan.

(3) What is the monthly entry amount of retirees?

The unified monthly income of retirees in Shenzhen is: 60%*8.05% of the social wage in the previous year, and 12964*60%=7778 yuan after July 2022.

(1) The monthly payment for medical insurance is: 7778 * 8.05% = 626.438+03 yuan.

(2) The monthly medical subsidy is 20 yuan (40 yuan after 70 years of age).

The minimum monthly entry amount of personal account is 646. 13 yuan.

If the insured pays the basic medical insurance premium at 8%, it will be included in the personal account at 5% of the payment base on a monthly basis; Among them, those who have reached the age of 45 will be included in the personal account on a monthly basis at 5.6% of the payment base.

Fourth, the proportion of personal account return.

City social insurance institutions to establish personal accounts for the basic medical insurance class I insured, mainly used to pay for outpatient medical expenses. The specific ratio is as follows:

(a) if the insured pays the basic medical insurance premium at 8%, it will be included in the personal account at 5% of the payment base; Among them, those who have reached the age of 45 will be included in the personal account on a monthly basis at 5.6% of the payment base;

(2) If the insured pays the basic medical insurance premium according to 1 1.5%, it will be included in the personal account according to 8.05% of the payment base; If the medical insurance premium is paid in one lump sum, the part that should be included in the personal account shall be included in the personal account monthly;

(three) the insured person to stop payment and continue to enjoy the basic medical insurance treatment, more than 60% of the average monthly salary of workers in this city as the base, monthly included in the personal account, the cost paid by the serious illness fund.

Personal account use

1, basic medical insurance A personal account of the insured person is used to pay the insured person's outpatient basic medical expenses, local supplementary medical expenses, and the expenses of purchasing drugs in the medical insurance catalogue at designated retail pharmacies with prescriptions issued by doctors in designated medical institutions in this city. The part that is not paid in the personal account shall be paid by the individual.

2. If the accumulated storage amount of personal accounts of the first-class insured persons in basic medical insurance exceeds 5% of the average wage of employees in this Municipality in the previous year (that is, 7778 yuan), the excess can be used to pay the following expenses:

(1) The expenses for purchasing non-prescription drugs within the scope of the basic medical insurance and local supplementary medical insurance drugs list in designated retail pharmacies;

(two) the basic medical expenses and local supplementary medical expenses paid by myself, my spouse and the immediate family members who have participated in the basic medical insurance in this Municipality when they visit the designated medical institutions;

(three) the cost of health examination and vaccination for himself and his spouse and his immediate family members who have participated in the basic medical insurance in this Municipality;

(four) other medical expenses stipulated by the state, Guangdong Province and this Municipality.

Tips: WeChat search Shenzhen local treasure, official account of WeChat. After paying attention, you can reply to the medical insurance in the dialog box to obtain relevant information such as Shenzhen medical insurance business entrance, medical insurance payment standard, medical insurance reimbursement ratio and reimbursement process, and medical insurance level change.

legal ground

People's Republic of China (PRC) Social Insurance Law (revised on 20 18)

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.