What is the difference between medical insurance for urban flexible employees, medical insurance for urban and rural residents and medical insurance for urban employees?

First, medical insurance for urban workers:

Payment method:

Enterprises pay about 6% of the total wages in the previous year (there are differences in different regions, and some areas have merged medical insurance and maternity insurance, paying about 7%), and individuals pay about 2% of the average monthly wages in the previous year (counted as personal accounts), which are withheld and remitted by enterprises in their monthly wages and paid monthly. The unit payment is divided into two parts, one part is used to establish the overall fund (hospitalization reimbursement), and the other part is directly transferred to the personal account (generally, the older you are, the higher the proportion of personal account transfer).

Personal account of medical insurance:

The individual contributions of employees are all included in personal accounts, and the unit contributions are included in personal accounts. Personal account of medical insurance is mainly used for outpatient service and drug purchase.

Hospitalization reimbursement:

In accordance with the "national basic medical insurance drug list", hospitalization expenses can be reimbursed according to the prescribed proportion. There are differences in specific reimbursement rates and reimbursement methods in different regions.

Medical insurance transfer:

The general process of transfer: print the basic medical insurance certificate from the transfer-out place and then give it to the transfer-in place.

Medical insurance benefits after retirement:

After the employee retires, if the accumulated payment of medical insurance (including deemed payment) reaches a certain number of years, he will no longer pay after retirement and enjoy medical insurance benefits for life. There are differences in the minimum payment period standards of medical insurance implemented in different regions, which generally require cumulative payment of 20, 25 or 30 years.

Second, medical insurance for flexible employees:

Freelancers, self-employed and other flexible employees can participate in medical insurance for flexible employees. This is a "simple and flexible version" of urban workers' medical insurance, and the payment method is more flexible, and its contribution fund is also included in the unified management of employees' medical insurance fund.

Payment method:

There are obvious differences in medical insurance payment policies for flexible employees in different regions. The medical insurance premium for flexible employees generally refers to the social average wage base and is paid according to the proportion of employee medical insurance (unit+individual). In some areas, insured persons are allowed to choose their own project combinations such as "personal account", "outpatient large-scale medical care" and "inpatient medical care", and choose different payment grades and security levels. The level of payment varies greatly in different regions, with the general level ranging from 2,000 yuan to 4,000 yuan per year.

Waiting period for medical insurance benefits:

In order to prevent the situation of "re-insurance after serious illness", flexible employees can not enjoy medical insurance benefits immediately after participating in medical insurance, but can enjoy medical insurance benefits (especially hospitalization medical insurance benefits) after the "waiting period for medical insurance benefits" (such as 6 months).

Payment interruption:

The payment of basic medical insurance is suspended for no more than 3 months, and the payment of medical insurance premiums during the suspension period is not limited by the waiting period.

Policies such as hospitalization reimbursement, medical insurance transfer and post-retirement medical insurance benefits for flexible employees are generally consistent with the medical insurance policies of enterprise employees.

Three, medical insurance for urban and rural residents:

The medical insurance for urban and rural residents includes the original medical insurance for urban residents and all insured persons of the new rural cooperative medical system, that is, it covers all other urban and rural residents (including rural residents, urban residents, students, children, etc.). ) except for the insured of basic medical insurance for employees.

Migrant workers and flexible employees participate in the basic medical insurance for employees according to law. If they have difficulties, they can participate in medical insurance for urban and rural residents in accordance with local regulations, but they should avoid repeated insurance.

Payment method:

In 2022, the per capita financial subsidy standard for medical insurance for urban and rural residents shall be no less than 550 yuan per person per year, and the individual payment standard shall be 280 yuan per person per year. Pay once a year, pay in that year and enjoy the treatment in the following year.

No personal account, no accumulated years, transfer:

There is no personal account for medical insurance for urban and rural residents. Cancel the areas where individual (family) accounts have been implemented before the end of 2020.

Medical insurance benefits:

Medical insurance for urban and rural residents adopts mechanisms such as reimbursement of hospitalization expenses, serious illness insurance and outpatient expenses. There are differences in treatment policies in different regions, so it is necessary to consult or consult the local medical insurance treatment policies for urban and rural residents.

Summary: The main differences between the three types of medical insurance.

1, the medical insurance payment level of enterprise employees is high, and the treatment level is high;

2. The medical insurance for flexible employees is also "employee medical insurance" in essence, but the payment method is more flexible, and the payment is generally calculated according to the average social wage base.

3. The medical insurance for urban and rural residents has obvious "social welfare" nature, and the financial subsidy (520 yuan) is obviously higher than the individual contribution (250 yuan).

4. Medical insurance for enterprise employees and flexible employees can be accumulated and transferred across regions. After the payment reaches a certain number of years (such as 20 years, 25 years or 30 years, depending on the region), you can enjoy medical insurance benefits for life after retirement. Medical insurance for urban and rural residents needs to be paid all the time in order to enjoy medical insurance treatment all the time.