Legal analysis: Shenzhen health insurance first and second class in addition to outpatient treatment of major diseases are based on the length of continuous participation by the integrated fund to pay 60% -90%, the difference is still a lot of, mainly including the following:
1, the contribution standard
Shenzhen health insurance first class: the proportion of contribution is 8.2% (basic +) The first grade of Shenzhen medical insurance: the contribution rate is 8.2% (basic + local supplement), of which the unit to pay 6.2%, individual contributions to pay 2%.
Shenzhen medical insurance first class: monthly contribution of 59.84 yuan, of which, the individual to pay 14.96 yuan, the unit to pay 44.88 yuan.
2, general outpatient treatment
Shenzhen medical insurance first class: individual account for the payment of participants in the general outpatient medical insurance catalog range of medical expenses. The basic medical expenses of the community health center, 70% paid by the individual account, 30% paid by the integrated fund in accordance with the provisions.
Shenzhen medical insurance first class: belonging to class A drugs and class B drugs, respectively, by the community outpatient coordinated fund at the rate of 80% and 60%; belonging to the medical insurance directory of a single diagnosis and treatment or medical materials, by the community outpatient coordinated fund to pay 90%, but the maximum amount of payment is not more than 120 yuan; the community outpatient coordinated fund to pay to each of the second class of the participant's outpatient medical fees in a The total amount of outpatient medical expenses paid by the Community Outpatient Coordination Fund to each participant of the second class in a medical insurance year shall not exceed 1000 yuan.
The difference between Shenzhen's first and second class social security
3, personal account family **** relief
Shenzhen medical insurance first class: personal account accumulation amount exceeds 5% of the city's last year's average salary of on-the-job workers, more than the part of the designated pharmacy to buy medical insurance catalog range of over-the-counter medicines; can be for themselves and their spouses and immediate family members have participated in the city's basic health insurance Payment of basic medical expenses, local supplementary medical expenses, health check-up expenses and preventive vaccination expenses paid out-of-pocket when they visit the designated medical institutions.
Shenzhen medical insurance second grade: None
4, personal account insufficient payment
Shenzhen medical insurance first grade: continuous participation in the insurance for one year, in the same medical insurance year, out-of-pocket outpatient basic medical expenses and local supplemental medical expenses more than the average salary of the employees on duty 5%, the part of the exceeding portion of the integrated fund in accordance with the provisions of the 70% (70 years of age or older to pay 80%). Shenzhen medical insurance second grade: none
5, outpatient large equipment inspection and treatment costs
Shenzhen medical insurance first grade: the coordinated fund in accordance with the provisions of the 80%
Shenzhen medical insurance second grade: according to the general diagnosis and treatment of the unit price of up to 120 yuan
6, general outpatient blood transfusion costs
Shenzhen medical insurance first grade: by the coordinated fund to pay 90%
Shenzhen medical insurance first grade: by the coordinated fund Pay 90% according to regulations
Shenzhen medical insurance second class: 70% by the coordinated fund according to regulations
7, physical examination subsidies
Shenzhen medical insurance first class: a lump sum of 500 yuan after retirement, 20 yuan per person per month (70 years of age for each person per month of 40 yuan) Shenzhen medical insurance first class:
8, in the city outside of the treatment of medical treatment
Shenzhen medical insurance First class: general outpatient expenses, outpatient expenses for major diseases and hospitalization costs can be reimbursed in accordance with the provisions
Shenzhen medical insurance first class: general outpatient expenses will not be reimbursed; in line with the provisions of the outpatient expenses for major diseases and hospitalization costs can be reimbursed in accordance with the provisions of the provisions.
Legal basis: "Chinese People's **** and State Social Insurance Law"
Article 2 The State establishes a social insurance system of basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance, maternity insurance and other social insurance systems, to safeguard the citizens' right to obtain material assistance from the State and society in accordance with the law in the event of old age, illness, industrial injury, unemployment and maternity.
Article 3 The social insurance system adheres to the policy of broad coverage, basic protection, multi-level and sustainability, and the level of social insurance shall be commensurate with the level of economic and social development.