Recent health care reform civil servants and career retirees hospitalization cost reimbursement is different

There is a big difference between civil servants and career medical insurance reimbursement. First of all, civil servants' health insurance reimbursement is paid by the state treasury, while the health insurance reimbursement of the career establishment is paid by the unit or individual. Secondly, the health insurance reimbursement for civil servants is more flexible and can reimburse most of the medical expenses, whereas the health insurance reimbursement for career staff is more restricted and can only reimburse part of the medical expenses. In addition, civil servants' health insurance claims are subject to stricter regulation, whereas career health insurance claims are not. In short, there is a big difference between civil servants and career medical insurance reimbursement, which needs to be rationalized according to the actual situation.

The difference between civil servants and career medical insurance reimbursement is mainly the following:First, the form of participation is different: civil servants are participating in the basic pension insurance, career medical insurance is to participate in the basic medical insurance. Second, the scope of reimbursement is different: civil servants reimbursement scope is broader, can reimbursement of hospitalization costs, examination costs, drug costs, etc.; and the establishment of health insurance reimbursement scope is narrower, can only reimbursement of hospitalization costs. The reimbursement rate is different: the reimbursement rate of civil servants is generally higher, which can reach over 90%, while the reimbursement rate of career health insurance is generally lower, which is generally not more than 70%. Fourth, the reimbursement method is different: the reimbursement method of civil servants is generally direct reimbursement, that is, the reimbursement expenses can be directly deducted from the participating units; while the reimbursement method of the career health insurance is generally indirect reimbursement, that is, the reimbursement expenses need to be paid to the medical insurance bureau, and then the medical insurance bureau to the participating units to issue reimbursement expenses.

What is the difference between public health care and medical insurance for civil servants

1, the concept is different.

Medicare refers to social medical insurance. Social medical insurance is a social insurance system established by the state and society in accordance with certain laws and regulations, in order to provide protection to the workers covered by the basic medical needs in case of illness.

Publicly-funded medical care refers to a social security system implemented by the state to protect state workers by providing free medical care and preventive services to those who enjoy it through the medical and health sector in accordance with regulations.

2, the coverage of the population is different.

Medicare covers workers and residents, but public health care is limited to civil servants.

3. The scope of coverage is different.

The public medical insurance coverage is larger than the medical insurance, and the reimbursement rate is higher.

4, the burden of different subjects.

Publicly funded medical care is borne by the unit, included in the department's budget; due to emergency can not go to the designated medical unit, in the nearest medical unit for medical expenses.

Medicare is paid for by the Social Security Fund, and those who are entitled to it are all enterprise employees and former employees of divested institutions.

5, the reimbursement rate is different.

Publicly funded medical care is the unit to pay, reimbursement of all. People who are entitled to publicly-funded medical treatment, the medical costs of medical treatment in designated medical units.

And health insurance is in accordance with the national, provincial and municipal regulations reimbursement rate.

I hope the above can help you, if there are still questions please consult a professional lawyer.

Legal basis:

Article 80 of the Civil Servants Law

Civil servants' salaries include basic salaries, allowances, subsidies and bonuses.

Civil servants are entitled to allowances such as additional regional allowances, allowances for difficult and remote areas, and postal allowances in accordance with state regulations.

Civil servants enjoy housing, medical and other allowances and subsidies in accordance with state regulations.

Civil servants who are recognized as excellent or competent in the regular appraisal are entitled to year-end bonuses in accordance with State regulations.

Civil servants' salaries shall be paid in full and on time.