There are three ways to pay for medical insurance in Beijing, one is the urban and rural residents' medical insurance, one is the employees' medical insurance, and one is the freelancer's medical insurance.
These three urban and rural residents health insurance is in fact our common understanding of the "new rural cooperative", it and freelance insurance can only be paid in the hukou location, so these two kinds of health insurance can only be paid for Beijing hukou, foreign hukou can only be paid through the work of the unit after the employee insurance.
There is also a difference in the contributions of these three, as follows:
From the chart above, it can be seen that the urban and rural residents of the medical insurance contribution is fixed, and the contribution mode is annual, for 520 yuan a year.
The urban workers' medical insurance contribution is paid according to the salary base, and the formula is: "total contribution = contribution base * individual contribution ratio + contribution base * company contribution ratio".
Taking the example of Wang, who works in Beijing with a monthly salary of 7,000, and applying the above formula, the cost of his medical insurance in the case of normal payment is "7,000*2%+3+7,000*10.8%=143(individual)+756(unit)=899", because Beijing's medical insurance is calculated in conjunction with maternity insurance. Because Beijing's health insurance and maternity insurance are combined, this contribution includes maternity insurance costs.
Flexible employment health insurance is also calculated according to the base of payment, the upper limit is 26,541 yuan, the lower limit is 3613 yuan, within this range to choose their own base of payment, and can not be changed within one year after the choice. Policies vary from place to place, and other areas are subject to local social security bureaus.
Calculated by "payment = payment base * payment ratio", according to their own choice of payment base and the local payment ratio can be multiplied, note that this is a monthly fee, the annual cost can be multiplied by 12.
Because of these three kinds of insurance payment costs are different, the enjoyment of the treatment is not the same, in fact, flexible employment insurance is also belong to a kind of employee insurance so these two insurance reimbursement ratio is the same.
From the table above, the reimbursement rate and the maximum benefit amount of employee health insurance are higher than that of resident health insurance.
But the threshold for reimbursement is also higher, with reimbursement starting at more than 1,800 yuan per year.
Take two examples, you can see the difference
Example 1
If Wang is sick to go to the community hospital to see a doctor, the total **** spent 2400 yuan, if the employee health insurance reimbursement, the calculation is (2400-1800)*90% = 540 yuan; if Wang is a resident of the medical insurance, the same go to the community hospital, the reimbursement cost is
: (2400-100)*55%=1265 yuan.
Example 2
If Wang goes to a community hospital and spends a total of 30,000 yuan, he will be reimbursed 25,380 yuan if he is reimbursed by the employee health insurance; if he is reimbursed by the resident's health insurance, he will be reimbursed 16,445 yuan; however, the maximum payout for the resident's health insurance is only 4,000 yuan/year, so he will be reimbursed only 4,000 yuan in reality.
It can be seen that in the case of spending a small amount of resident health insurance reimbursement than the employee health insurance reimbursement a little more; on the contrary, spending a large amount of money, the employee health insurance reimbursement than the resident health insurance a lot more.
Take a look at the hospitalization reimbursement rate, as shown in the table below:
Two more examples
Example 1
Wang was hospitalized in a tertiary hospital and spent 80,000 yuan after deducting out-of-pocket expenses, and was reimbursed by the employee's social security as follows:
No reimbursement for less than 1,300 yuan, and reimbursement needs to be divided into segments
1300 -30,000 (30,000-1,300)*85%=$24,395
30,000-40,000 (40,000-30,000)*90%=$9,000
40,000-8,000 (80,000-40,000)*95%=$38,000
The three add up to a total reimbursement of: $71,395
Example 2
In the same case, if Xiao Wang uses the resident health insurance to claim, the reimbursement does not need to be segmented, and the final reimbursement is:
(80,000-1,300)*75%=59,025 yuan
In this case, the employee's health insurance is a little bit more than the resident's health insurance. Xiaodou social security advice, where possible or choose to pay the town health insurance is best, in addition to medical reimbursement than the residents of health insurance, there are pensions and other insurance are also residents of health insurance do not have.
Additionally there is a benefit of paying 25 years for urban workers' health insurance to enjoy life-long health insurance, and residents' health insurance must be paid every year.