The conditions for enjoying employee medical insurance benefits are: the minimum payment years (including deemed payment years and actual payment years), which must be 25 years in total for male employees and 20 years in total for female employees, of which the actual payment years must be at least 10 years in total.
_1. How many years of medical insurance do you need to pay? The conditions for enjoying employee medical insurance benefits are: minimum payment years (including deemed payment years and actual payment years), male employees have a total of 25 years, and female employees have a total of 20 years, of which the actual
The payment period should be at least 10 years in total.
2. Provisions on basic medical insurance Article 23 of the "Social Insurance Law" Employees shall participate in the basic medical insurance for employees, and the employer and employees shall jointly pay the basic medical insurance premiums in accordance with national regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other people with flexible employment can participate in the basic medical insurance for employees, and individuals must pay the basic medical insurance premiums in accordance with national regulations.
Article 24 The state establishes and improves a new rural cooperative medical system.
The management measures for the new rural cooperative medical system shall be stipulated by the State Council.
Article 25 The state establishes and improves the basic medical insurance system for urban residents.
The basic medical insurance for urban residents combines individual contributions and government subsidies.
The government subsidizes the required personal contributions for people who enjoy the minimum living security, disabled people who have lost the ability to work, elderly people over 60 years old and minors from low-income families.
Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical insurance and basic medical insurance for urban residents shall be implemented in accordance with national regulations.
Article 27 If an individual who participates in the basic medical insurance for employees reaches the statutory retirement age and has paid cumulative contributions for the number of years specified by the state, he will no longer pay basic medical insurance premiums after retirement and will enjoy basic medical insurance benefits in accordance with the regulations of the state;
Yes, you can pay until the number of years specified by the state.
Article 28 Medical expenses that comply with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency and rescue expenses shall be paid from the basic medical insurance fund in accordance with national regulations.
Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance fund shall be settled directly between the social insurance agency and the medical institution and pharmaceutical business unit.
The social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in other places to facilitate insured persons to enjoy basic medical insurance benefits.
Article 30 The following medical expenses are not included in the payment scope of the basic medical insurance fund: (1) Should be paid from the work-related injury insurance fund; (2) Should be borne by a third party; (3) Should be borne by the public health department
; (4) Seeking medical treatment abroad.
Medical expenses should be borne by a third party in accordance with the law. If the third party fails to pay or the third party cannot be identified, the basic medical insurance fund shall pay first.
After the basic medical insurance fund has paid in advance, it has the right to recover compensation from the third party.
Article 31 Social insurance agencies may sign service agreements with medical institutions and pharmaceutical business units to standardize medical service behavior based on the needs of management services.
Medical institutions should provide reasonable and necessary medical services to insured persons.
Article 32 If an individual is employed across a coordinating area, his or her basic medical insurance relationship will be transferred with the individual, and the years of payment will be calculated cumulatively.
What is the medical period? What are the regulations on the medical period for employees who are sick or injured not due to work? According to the "Regulations on the Medical Period for Enterprise Employees Sick or Injured Not Due to Work" issued by the former Ministry of Labor in 1994, the medical period refers to
The employer cannot terminate the labor contract within the time limit when an employer's employee stops working for medical treatment and rest due to illness or non-work-related injury.
The "Regulations on Medical Treatment Periods for Enterprise Employees Sick or Non-Work-related Injuries" issued by the former Ministry of Labor in 1994 mainly include the following provisions on the medical period: (1) Enterprise employees need to stop work for medical treatment due to illness or non-work-related injuries.
At that time, a medical period of 3 months to 24 months will be given based on the person's actual working years.
If the actual working experience is less than 10 years, it will be 3 months if the employee has worked in the unit for less than 5 years; if it is more than 5 years, it will be 6 months.
For those with actual working years of more than 10 years, 6 months for those who have worked in the unit for less than 5 years; 9 months for those who have worked for more than 5 years and less than 10 years; 12 months for those who have worked for more than 10 years and less than 15 years; 20 months for those who have worked for more than 15 years.
18 months for those under 20 years old; 24 months for those over 20 years old.
(2) A medical treatment period of 3 months shall be calculated based on the accumulated sick leave time within 6 months; a medical treatment period of 6 months shall be calculated based on the accumulated sick leave time within 12 months; a medical treatment period of 9 months shall be calculated based on the accumulated sick leave time within 15 months; 12 months
The accumulated sick leave time within 18 months will be calculated as the accumulated sick leave time within 18 months; the accumulated sick leave time within 24 months will be calculated as the accumulated sick leave time within 30 months.
(3) During the medical treatment period, the sick leave wages, disease relief payments and medical insurance benefits of enterprise employees shall be in accordance with the regulations of relevant departments.