1. Personal account consists of two parts. Part of it is withheld by individuals, accounting for 2% of the monthly salary base, and all of it goes into personal accounts. The other part is paid by enterprises, and the proportion of personal accounts varies with age. Part of the basic medical insurance premium paid by the employer is transferred to the personal account: employees under 35 years old are transferred to the personal account according to 0.8% of their monthly salary base; Employees over 35 years old and under 45 years old will be transferred to personal accounts according to 1% of their monthly salary base; Employees over the age of 45 are included in personal accounts according to 2% of their monthly salary base; Retirees under 70 years old are credited to personal accounts according to 4.3% of the average monthly salary of employees in this city in the previous year, and retirees over 70 years old are credited to personal accounts according to 4.8% of the average monthly salary of employees in this city in the previous year. Scope of use of medical insurance card: 1. The medical insurance card is divided into two accounts, the personal account, and the money reflected by the medical insurance card can be used to buy medicines at designated pharmacies, pay for outpatient expenses and pay for hospitalization expenses. The overall account is managed by the medical insurance center, and the expenses incurred by the insured who meet the local medical insurance reimbursement are paid by the overall account. 2. When seeking medical treatment, show the medical insurance card to the designated hospital to prove the identity and registration of the insured. The part of medical insurance reimbursement is settled by medical insurance and hospitals, and individuals do not need to pay in advance before reimbursement. At the time of checkout, the part paid by the individual is paid by the balance of the medical insurance card and cash.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 24 The state establishes and improves the new rural cooperative medical system. Measures for the administration of the new rural cooperative medical system shall be formulated 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 with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.
Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Derivative problem:
Has the amount of medical insurance transferred to personal accounts decreased?
First of all, the personal account of medical insurance for employees will be reduced, in which employee medical insurance consists of two parts, one part is paid by individuals, accounting for 2%, and the other part is paid by units, accounting for 7%. Before the medical insurance reform, the amount in the personal account was composed of the total amount paid by the individual plus 30% of the amount paid by the unit. After the implementation of the new regulations, in order to establish the outpatient service mechanism, only the part paid by the individual will be included in the personal account, while the part paid by the unit will not be included in the personal account, but will be aggregated into the medical insurance pooling fund, so the amount in the personal account will inevitably decrease. Secondly, the amount of medical insurance personal accounts for retired employees will also decrease. On-the-job employees can retire after reaching retirement age, but their personal medical insurance accounts will also lose the part paid by their units, so the accumulated years of personal medical insurance will play a crucial role. Among them, retired employees who meet the local regulations for medical insurance payment can enjoy lifelong medical insurance benefits. Generally, men have to pay 25 or 30 years, and women have to pay 20 or 25 years. Benefits include refund of money with medical insurance card and reimbursement for hospitalization.