And the grades of the health insurance are divided into three levels
The first two grades of the health insurance are the first, second and third grades
Many people know the difference between the first and second grades. p>That is, the first, second and third class
Many of my friends do not know the exact difference between them Today I will take you to understand in detail! Before answering your questions, let's be clear about one thingSocial security includes pension insurance, medical insurance
Only medical insurance is graded
The rest of the four are not graded
The rest of the four are not graded
And the rest is not graded.
Shenzhen social security, the difference between the first, second and third
___ employees to participate in the first class of medical insurance, to the employee's monthly gross salary or the standard monthly contributions, which the employer to pay or personal contribution of 2%.The second class of medical insurance contribution base for the average monthly salary of employees on duty in Shenzhen in the previous year, the proportion of contributions for the basic medical insurance + local supplementary medical insurance), of which the unit to pay the individual to pay src="/mmbiz_jpg/ mXWhsUD9ZRk6Jofkiah31ABa5Fv03ib66B65P7iac7tWhoIVQ5OtvDzMwufeGRUX5aVHHL554sfmxna4FV5tC8Bibw/640?wx_fmt=jpeg"/>
The third class of the medical insurance contribution base for the Shenzhen City on the average monthly salary of workers. The annual average monthly salary of on-the-job workers in Shenzhen, the contribution ratio for the basic medical insurance + local supplementary medical insurance), of which the unit to pay the individual to pay if you are a medical insurance three, medical insurance monthly contribution of yuan, of which the individual contribution of yuan. The first class participants: any designated medical institutions in the city.The second class of participants: outpatient treatment in the bound community health centers, hospitalization in the city at any point of medical institutions, outpatient major diseases in the prescribed medical institutions.
Third class participants: outpatient treatment at the bound community health center, inpatient treatment and outpatient treatment of major diseases at the prescribed medical institutions.
First class participants: Whether you are a Shenzhen resident or a non-Shenzhen resident, you can go to any designated medical institution in the city for outpatient treatment, hospitalization and reimbursement by credit card.
The second class of insured people: No matter whether you are a Shenzhen or non-Shenzhen household, you have to go to the bound community health clinic for outpatient treatment. If you are hospitalized, you can go to any designated medical institution in the city.
Three-stage participants: Whether outpatient or hospitalization, it is necessary to go to the bound medical institutions.
In the Shenzhen Chacha Bar public dialog box send Social Security to get the relevant entrance online _General outpatient treatment
___First-tier enrollment: Individual accounts are used to pay for medical expenses within the scope of the participant's general outpatient medical insurance catalog. 70% of the basic medical expenses of the social welfare center are paid by the individual account, and 30% are paid by the integrated fund according to the regulations.
Second-tier participants/third-tier participants: 80% and 60% of the cost of Class A and Class B drugs, respectively, shall be paid by the community outpatient fund;
90% of the cost of a single diagnosis, treatment or medical material that belongs to the medical insurance catalog shall be paid by the community outpatient fund, but the maximum amount of the payment shall not be more than 120 yuan;Community outpatient funds shall be used for the payment of basic medical expenses of community outpatient centers, 70% shall be paid by individual accounts, and 30% shall be paid by the integrated fund according to the regulations.
The total outpatient medical expenses paid by the Community Outpatient Coordination Fund to each participant in the second and third categories shall not exceed RMB 1,000 in a medical insurance year.
First-tier participants: The amount accumulated in the individual account exceeds 5% of the average salary of on-the-job workers in the previous year in the city, and the excess can be used to purchase non-prescription medicines within the scope of the medical insurance catalog at the designated pharmacies, and to pay for the out-of-pocket expenses for the basic medical expenses incurred by the participants and their spouses and relatives who have already taken part in the basic medical insurance in the city, and for the local supplementary medical expenses.
Second class insured/third class insured: No, you can't use your social security card to buy medicines at the pharmacy.
First-tier participants: First-tier participants have been continuously insured for one year, in the same medical insurance year, out-of-pocket outpatient basic medical expenses and local subsidized medical expenses supermarkets in the average salary of the workers on the job of 5%, the part of the excess is paid by the integrated fund in accordance with the provisions of the 70% (70 years of age and older to pay 80%).
___ The first class of participants: 80% of the total fund will be paid in accordance with the regulations.The first class of participants: 90% of the total fund in accordance with the provisions of the payment.
The second participant/third participant: 70% of the total amount will be paid by the integrated fund according to the regulations.
The first participant / second participant / third participant: according to the length of continuous participation in the integrated fund to pay 60% - 90%. First-class participants, second-class participants: hospitalization of basic medical costs and local supplementary medical costs above the starting line part of the prescribed payment of 95% or 90%. 1, can be bound to the community health center settlement hospital, or through the settlement of hospital referral to the provisions of the hospital, the basic medical costs incurred in hospitalization and local supplemental medical costs, hospitalization above the starting line of the part of the reimbursement rate:First-class hospitals: 85%
Second-class hospitals: 80%.
Tertiary hospitals:75%
2. If you are hospitalized in a prescribed hospital other than the billing hospital without referral, you will be paid 90% of the inpatient hospitalization payment standard of the hospital you visited (i.e., the payment standard in Article 1 above).Participants in the first tier: general outpatient expenses, outpatient expenses for major diseases, and hospitalization expenses are all reimbursed according to the regulations.
Second class participants/third class participants: general outpatient expenses are not reimbursed, but outpatient expenses for major illnesses and hospitalization expenses can be reimbursed according to the regulations.
Modification of health insurance in Shenzhen
___ If you are a Shenzhen employee, the employer must enroll you in the first level of health insurance, and you cannot change the level. If you are a non-Shenzhen employee, the employer can choose a form of participation in the first, second and third tranches of the health insurance, the same unit has only one opportunity per year to change the basic health insurance tranches for the employees of the unit (generally from July 1 to July 20) If you have been in the Shenzhen household, tell the relevant responsible person in charge of the company, in the system can be modified, do not need to wait until the unified modification of the health insurance tranches of time.
In addition, the flexible employment of health insurance changes, not once a year limit (personal payment of social security can only pay the first or second class).
The conversion of different health insurance programs does not affect the calculation of the accumulated contribution period and the continuous contribution period. After reading the above detailed introduction I believe that you have a comprehensive understanding of the difference between the three grades of health insurance If you still do not understand the problem You can leave your doubts in the comments section Oh! Online social security tips ___ 1 catty 100000 yuan? Don't throw it away, Shenzhen people have a maximum subsidy of 2,000 yuan at home! Shenzhen consumer electronics and household appliances purchase subsidy application begins