Social medical insurance in this Municipality is divided into social medical insurance for employees and social medical insurance for urban and rural residents, with different grades according to payment standards and treatment levels. Article 4 This Municipality shall establish and improve the supplementary medical insurance system, including medical insurance for serious illness, to meet the multi-level medical security needs of the insured. Article 5 The municipal, district and county-level municipal people's governments shall incorporate social medical insurance into the national economic and social development plan, ensure and gradually increase the investment in social medical insurance, and improve the social medical security level of the insured.
The municipal, district and county-level municipal people's governments shall expand the coverage of service outlets of social insurance agencies and establish a social medical insurance information system with perfect functions, efficient operation, safety and reliability. Article 6 The municipal social insurance administrative department shall be in charge of social medical insurance in this Municipality and organize the implementation of these Regulations.
Municipal development and reform, finance, health, civil affairs, taxation, education, science and technology, information technology, public security, price, food and drug, auditing and other relevant administrative departments shall, in accordance with their respective responsibilities, cooperate in the implementation of these regulations. Seventh social insurance agencies in this Municipality are responsible for the daily service of social medical insurance, such as insurance registration, rights record, treatment payment, consultation, supervision and management of designated medical institutions and retail pharmacies, and business guidance.
The social insurance premium collection agency of this Municipality is responsible for the collection of social medical insurance premiums. Article 8 Sub-district offices, town people's governments and various schools shall, in accordance with the provisions of the second and third paragraphs of Article 25 of these Regulations, assist social insurance agencies and social insurance premium collection agencies to handle matters related to social medical insurance for urban and rural residents and students in their respective jurisdictions. Article 9 People's governments at all levels, social insurance administrative departments, social insurance agencies, neighborhood offices, villagers' committees and residents' committees should strengthen the publicity of social medical insurance knowledge, improve the enthusiasm of the whole people to participate in social medical insurance, and gradually realize full coverage of social medical insurance.
Newspapers, radio, television, Internet and other media in this Municipality shall cooperate with social insurance administrative departments and social insurance agencies to carry out public welfare publicity of social medical insurance. Article 10 This Municipality's Social Insurance Supervision Committee consists of a public consultation and supervision committee on social medical insurance, which is composed of deputies to the National People's Congress, members of the Chinese People's Political Consultative Conference, medical and health experts, social insurance experts, insured persons, employers and trade union representatives, and its working funds are guaranteed by the municipal finance.
The municipal administrative department of social insurance shall solicit the opinions of the public consultation and supervision committee of social medical insurance and adopt its reasonable opinions when organizing the formulation of policies and rules of social medical insurance in this Municipality.
Social medical insurance public consultation and supervision committee and its members have the right to supervise the implementation of social medical insurance laws, regulations and rules by social insurance administrative departments, social insurance agencies, social insurance premium collection agencies, social medical insurance fund financial account management agencies, designated medical institutions and designated retail pharmacies, and have the right to make suggestions to relevant administrative departments. Chapter II Social Medical Insurance Benefits Article 11 Employees in this Municipality shall participate in the social medical insurance for employees in this Municipality and enjoy the corresponding social medical insurance benefits for employees. Other personnel who meet the conditions prescribed by the state may choose to participate in social medical insurance for employees.
Retirees who participate in social medical insurance for employees when they reach the statutory retirement age, and have reached the period stipulated in Article 19 of these regulations, shall enjoy the corresponding social medical insurance benefits for employees in accordance with the regulations; If the payment fails to reach the prescribed time limit, the employee can enjoy the corresponding social medical insurance benefits after the payment reaches the prescribed time limit; Those who fail to pay the fees within the prescribed time limit, but have the household registration in this Municipality, can participate in the social medical insurance for urban and rural residents in this Municipality. Twelfth the following persons participate in the social medical insurance for urban and rural residents in this Municipality and enjoy the corresponding social medical insurance benefits for urban and rural residents:
(1) Full-time students of various schools in this Municipality;
(2) Preschool children, flexible employees, non-employees, rural residents and other persons with household registration in this Municipality. Thirteenth medical expenses incurred by the insured, by the social medical insurance fund and individuals in accordance with the provisions of the proportion of * * *.
The scope of medical expenses paid by the social medical insurance fund for the insured as mentioned in the preceding paragraph shall meet the following requirements:
(a) the provisions of the state and province on the scope of basic medical insurance drugs, diagnosis and treatment items, medical service facilities and payment standards;
(two) according to the relevant provisions of the state and province, the scope of medical service facilities and payment standards stipulated by this Municipality, as well as the scope of drugs needed during first aid and rescue;
(three) the relevant provisions of laws and regulations on social medical insurance.