1. How to pay for medical insurance for urban employees who are employed?
Employee medical insurance, under normal circumstances, the employer needs to pay 8% of the social security base (or recognized salary) every month, and individuals need to pay 2%, which is directly deducted from the salary every month, and when the legal retirement age is reached , men pay for 25 years, and women can enjoy life-long benefits after paying for 20 years.
This payment base is not static. It comes from the average salary of employees in this province and city in the previous year. The minimum payment base is 60% of the average social salary in the previous year, and the maximum is 300% of the average salary. For example, the average salary in Zhengzhou in 2018 was 4,575 yuan, so the minimum payment base in 2019 is 4,575 × 60 = 2,745 yuan, and the maximum payment base is 4,575 × 300 = 13,725 yuan.
As long as these two payment bases are determined, it means that no matter how low your salary is, even if it is less than 2,745 yuan, you must pay according to the minimum standard; if your salary is higher than 13,725 yuan, no matter how high it is, you must pay according to the highest standard. Standard payment is made, but if the salary is between 2745-13725, the payment is based on the actual salary.
For example, suppose Xiao Zhang works in a company in Zhengzhou with a monthly salary of 10,000.
Then the monthly medical insurance fee he needs to pay by the company = 10,000 × 8 = 800 yuan ,
Individuals only need to pay =10000×2=200 yuan.
2. How do unemployed urban and rural residents pay insurance?
The payment fee for urban and rural residents’ medical insurance is lower than that for employee medical insurance. The premium is generally determined according to a certain proportion of the local people’s per capita disposable income, but there is no retirement benefit. The payment is one year and the insurance is one year. At the same time, the government also Certain financial subsidies will be provided.
Under normal circumstances, urban and rural residents’ medical insurance (hereinafter referred to as urban residents’ insurance) must be paid in advance, that is, if you pay this year, you will enjoy the full-year medical insurance benefits of the following year. For example, in Zhengzhou, you only need to pay 250 yuan in 2019 to enjoy the benefits. If you do not pay for the medical insurance benefits throughout 2020, it means that you will not be able to enjoy medical insurance reimbursement the following year. The specific payment depends on local policies.
The annual payment time is usually concentrated in the second half of the year. When it is about to expire, the community will usually remind you that you can freely choose to pay or not. Especially now it is becoming more and more convenient to do things. You can renew your insurance directly by logging in to WeChat or Alipay.
How medical insurance hospitalization reimbursement is calculated, you can save more if you learn it
One thing is very important. Urban employee medical insurance and urban and rural residents medical insurance pay different fees, and the benefits they enjoy are also different. different.
The former pays more than the latter, and enjoys better treatment during reimbursement, which is mainly reflected in the reimbursement ratio. For the same level of hospital treatment and the same medication, the reimbursement ratio of employee medical insurance is generally higher than that of the latter. The reimbursement ratio of urban insurance is 10-20% higher. Taking Zhengzhou as an example, Baobei made a picture, and the difference is clear at a glance:
How is medical insurance hospitalization reimbursement calculated? If you learn how to calculate it, you can save more
For example, assume that Xiao Zhang was hospitalized in a tertiary hospital in Zhengzhou for a week due to appendicitis. During the period, the surgery and hospitalization fees cost 12,000 yuan, and all of them were medicines covered by social security.
If He is covered by urban and rural residents’ medical insurance,
The reimbursement amount = (8000-2000) × 55 = 3,300 yuan
(12,000-8,000) × 65 = 2,600 yuan
This means that he can eventually be reimbursed 3300 2600 = 5900 yuan, and needs to pay 6100 yuan out of pocket,
But if he uses urban employee medical insurance,
then the final reimbursement amount = (12,000 -900) Baoduo quoted 3,268 yuan, and finally saved nearly half of the cost!