A, urban and rural residents health insurance
2022 urban and rural residents health insurance financial subsidy standard for each person 610 yuan per year, the individual participation in the premium standard for each person 350 yuan per year.
Specifically, the following policies are in place for the participation and payment of special persons:
Full subsidies for special hardship cases and orphans (including de facto unsupported children), and fixed subsidies for low income recipients;
Fixed subsidies for those who are vulnerable to poverty in rural areas that are included in the monitoring scope of the program (households that are unstable to escape from poverty, households that are vulnerable to poverty in the periphery, households with sudden and severe difficulties);
Fixed subsidies for those who are recognized by the rural revitalization department as vulnerable to poverty;
Supported subsidies for those who are recognized by the rural revitalization department as vulnerable to poverty.
Fixed-rate subsidies will be provided to those who have returned to poverty as determined by the rural revitalization departments in accordance with the subsidy standards for low-income insurance recipients during the transitional period. Individual contributions from former rural family planning households will continue to be subsidized in accordance with the original policy.
The identification of the various categories of people who are entitled to subsidies for participation in insurance is based on the results of the relevant departments before August 31 of the year in which the contributions are made.
Second, flexible employment health insurance
2023 year has not yet opened
Contribution base: 2022 flexible employment health insurance 60% of the base is 4183 yuan, 100% of the base is 6971 yuan
Contribution ratio: 9%
Third, employee health insurance
Payment of the company's regular monthly
1, the employee's employer contribution rate is 8%, and the individual contribution rate of the active employees is 2%; the contribution rate of the unemployed insurance benefit recipients and the flexible employment is 9%.
2. For civil servants, staff of institutions governed by the civil service law and staff of fully funded institutions (hereinafter collectively referred to as "civil servants"), the contribution rate for the employer is 7.5%, and the contribution rate for individual civil servants is 2%.
Legal basis
The basic medical insurance for urban residents is governed by the Social Insurance Law of the People's Republic of China, with corresponding local policies. The basic medical insurance regulations for urban residents are as follows:
The People's Republic of China*** and the State Social Insurance Law
Chapter III Basic Medical Insurance
Article 23 Employees shall participate in the basic medical insurance for employees, and shall pay the basic medical insurance premiums for the employer and the employee in accordance with the provisions of the State*** together.
Individual industrial and commercial households without employees, part-time workers who do not participate in the basic medical insurance for employees in their employing units, and other flexibly employed persons may participate in the basic medical insurance for employees, and individuals shall pay the basic medical insurance premiums in accordance with the state regulations.
Article 24 The State establishes and improves the new rural cooperative medical care system.
Methods for administering the new type of rural cooperative medical care shall be prescribed by the State Council.
Article 25 The State establishes and perfects the basic medical insurance system for urban residents.
Basic medical insurance for urban residents is a combination of individual contributions and government subsidies.
The government shall subsidize the portion of individual contributions required by those who are entitled to the minimum subsistence guarantee, persons with disabilities who have lost their ability to work, and elderly persons and minors over sixty years of age from low-income families.
Article 26 The standards of treatment for basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with national regulations.
Article 27 Individuals participating in basic medical insurance for employees who have made contributions for a total of a specified number of years by the time they reach the legal retirement age shall not pay any more basic medical insurance premiums after retirement and shall enjoy basic medical insurance benefits in accordance with the state regulations; those who have not yet reached the state-specified number of years may make contributions for up to the state-specified number of years.
Article 28 Medical expenses that conform to the basic medical insurance drug list, diagnostic and treatment items, standards of medical service facilities, as well as those for emergency treatment and rescue, shall be paid out of the basic medical insurance fund in accordance with the state regulations.
Article 29 The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly between the social insurance administration organization and the medical institutions and drug business units.
The administrative departments of social insurance and the administrative departments of health shall establish a settlement system for medical expenses incurred for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance by insured persons.
Article 30 The following medical expenses shall not be included in the scope of payment by the basic medical insurance fund:
(1) those that should be paid from the workers' compensation insurance fund;
(2) those that should be borne by a third person;
(3) those that should be borne by the public ****health;
(4) those that seek medical treatment outside China.
Medical expenses shall be borne by a third person in accordance with the law, and if the third person fails to pay or if the third person cannot be identified, the basic medical insurance fund shall pay in advance. The basic medical insurance fund shall have the right to recover the costs from the third party after the payment is made.
Article 31 The social insurance administration organization may, in accordance with the needs of management and service, sign service agreements with medical institutions and drug business units to regulate the behavior of medical services.
Medical institutions shall provide reasonable and necessary medical services to insured persons.
Article 32 If an individual is employed across the integrated region, his basic medical insurance relationship shall be transferred with him, and the years of contribution shall be cumulative.