How to pay employee medical insurance and critical illness insurance?

There are two payment methods for employee's serious illness medical insurance: individual payment and unit payment.

Personal payment refers to the employee's own payment of insurance premiums in accordance with the prescribed proportion, generally a certain proportion of wages. Unit payment refers to the insurance premium paid by the employer for employees, which is generally applicable to employees in some special industries or under special circumstances.

Specifically, there are two ways for individuals to pay: one is to pay monthly, that is, to deduct a certain percentage of insurance premiums from wages every month and pay them directly to social security institutions by individuals; The second is annual payment, that is, one-time payment of insurance premium for one year, which is suitable for some employees with higher income.

However, the employer pays the insurance premium on behalf of the employer. Generally, a certain percentage of the insurance premium is deducted from the employee's salary, and then the employer pays it to the social security institution.

What are the protections for critical illness insurance?

1. reimbursement of hospitalization expenses: medical expenses incurred by employees during hospitalization can be reimbursed through major illness insurance, and the reimbursement ratio is generally between 70% and 90%.

2. Outpatient expenses reimbursement: In some areas, serious illness insurance can also reimburse employees' outpatient expenses to a certain extent, and the reimbursement ratio is generally between 30% and 50%.

3. Major illness allowance: critical illness insurance in some areas can also provide certain major illness allowance to help employees cope with the living expenses during treatment.

4. Referral reimbursement: When employees need to be referred to other medical institutions for treatment during medical treatment, the major illness insurance can reimburse the referral fee to a certain extent.

In short, through the above introduction, we can see that there are two payment methods for employees' medical insurance for critical illness: individual payment and unit payment, and the specific expenses are determined according to the employee's salary level and the regulations in the region. The protection of serious illness insurance mainly includes hospitalization expenses reimbursement, outpatient expenses reimbursement, major illness allowance and referral reimbursement.

I hope the above content can help you. Please consult a professional lawyer if you have any other questions.

Legal basis: Article 28 of the Social Insurance Law.

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

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, 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.