Ganzhou city medical insurance reimbursement ratio

Insurance editorial to help you answer, more questions can be online Q&A.

Medical Insurance Individual Enrollment Guide

Source:Ganzhou Medical Insurance Symbol:Ganzhou Medical Insurance

●Enrollment Scope

Within the scope of the working age range (male 60 years old, female 50 years old or below), the state-owned collective enterprises, the unemployed, the laid-off, and the institutions and institutions, and the freelance workers, who have realized employment or re-employment in a flexible and diversified form, such as part-time, temporary, seasonal, and flexible work, have been able to realize their jobs and reemployment. The laid-off and unemployed workers of state-owned and collective enterprises, the laid-off workers of institutions, the self-employed industrial and commercial households and their employees, the freelancers and other urban workers.

●Features of the insurance

*One payment, three hundred protections

Medical reimbursement of up to 158,000 yuan per year

Flexible employment, flexible choices

Depending on one's financial situation, an individual can choose to participate in the basic medical insurance or inpatient medical insurance

Flexible enrollment, equal enjoyment

Equal enjoyment

To be enrolled as an individual, a person can choose to join basic medical insurance or hospitalization medical insurance. p>

After joining the insurance as an individual, you can enjoy the same medical insurance treatment (including the scope of hospitalization at designated hospitals, the scope of medication, reimbursement standards, etc.)

●Payment standard (calculated on a natural year basis)

*To participate in the basic medical insurance

= Average social wage of on-the-job workers in Ganzhou City in the previous year×8% (contribution ratio) × 12 months + 60 Yuan/month (medical insurance premium for major illness subsidy). Annual (medical insurance premiums for major illnesses)

*Hospitalization medical insurance

= average social wage of employed workers in Ganzhou City in the previous year×5% (contribution rate)×12 months+60 RMB/year (medical insurance premiums for major illnesses)

●Materials to be brought

*Hukou, ID card (original and one copy);

*1 3 recent color photographs;

An employee who has terminated his/her labor relationship should also bring:

*Agreement on termination of labor relationship (original and a copy)

An unemployed person should also bring:

*Unemployment benefit certificate (original and a copy)

●Processing time

From the 1st to the 9th of each month

An unemployed person should bring:

An unemployed person should bring:

The unemployment benefit certificate (original and a copy). p>

●Processing place

Municipal Health Insurance Bureau, first floor business administration hall (No. 17 in front of the Shengfotan Municipal Office)

●Process of enrollment

1. From the 1st to the 9th of each month, the person himself or herself will bring the relevant enrollment materials (household registration, ID card, etc.) to the business administration hall to receive and fill out the individual enrollment registration form in duplicate;

2. The staff will review the enrollment materials and the individual enrollment form after they have passed.

3. After the participant pays the contributions, the staff will issue a financial receipt with the contribution slip;

4. After 90 days, the participant will apply for the medical insurance card and IC card with the contribution materials to receive the formalities and officially enjoy the corresponding benefits.

●Example

Mr. Zhang, 36 years old, a self-employed businessman, the contribution base is calculated according to the average social wage of on-the-job workers in Ganzhou City in 2006, which is 13,128 yuan (1,094 yuan per month).

●Option 1: Participate in the basic medical insurance

To pay the annual health insurance premiums of 1110.24 yuan, the monthly personal account can return about 30 yuan, which can be used for outpatient visits to designated hospitals and designated pharmacies to buy medicines and consumption, hospitalization can be reimbursed up to a maximum of 158,000 yuan a year.

●Option 2: Participate in inpatient medical insurance

The annual health insurance premium of 716.4 yuan is required to be paid, and no personal account is returned every month, and the treatment of hospitalization is the same as that of participating in basic medical insurance.

●Comparison of basic medical insurance and hospitalization medical insurance

*Differences:

(1) Contribution rate

Uniformly determined by the city's average salary of the previous year's on-the-job workers to determine the base of the contribution, hospitalization medical insurance contribution rate is 8%, the low-standard hospitalization medical insurance is 5%.

(2) Individual Accounts

Participants in basic medical insurance can set up individual accounts each month, which can be used for outpatient visits to designated hospitals and for purchasing medicines at designated pharmacies; individual accounts are not set up for participation in inpatient medical insurance. (3) The same way of settling medical bills

Uniformly using the medical insurance card and IC card issued by the Municipal Health Insurance Bureau to settle hospitalization expenses at designated hospitals

(4) The same application for additional medical subsidies for major illnesses

(5) The same choice of designated hospitals according to the actual situation of the person