Units pay premiums to individuals according to the situation.

The employer shall pay the basic medical insurance premium at 8% of the total wages. Pay transitional medical insurance for retirees at one time according to the number of retirees multiplied by 75% of the average wage of employees in the city in the previous year. 2% of the salary paid by the individual shall be withheld and remitted by the unit every month.

Individual annual premium is above 800 yuan.

In addition to 2% paid by the individual, 52.9% paid by the unit is temporarily transferred to the individual account. Specifically: firstly, transfer the basic fund of 100 yuan per year to the personal account of each insured person; Then it is divided into four grades according to age: employees under the age of 35 are divided into 1% of their salary, those aged 35 to 45 are divided into 2%, those aged 45 to before retirement are divided into 2.8%, and retirees are divided into 5. 1% of the average monthly salary of employees in the previous year. It is estimated that the personal account of Guangzhou insured is about 858 yuan per year.

The maximum payment limit this year exceeds 70,000 yuan.

According to different levels of hospitals, 80% ~ 90% of medical expenses are paid by the overall fund, and the rest are paid by individuals. Retirees pay 70% of the expenses for employees. Qifubiaozhun is determined by the hospital level according to 4% ~ 10% of the average salary of employees in the previous year. Specifically: 4% (759 yuan) of first-class hospitals; Secondary hospital 6% (1 138 yuan); Tertiary hospital 10% (1897 yuan). The maximum payment limit this year is about 75,800 yuan.

Excess cost capping line is 240,000 yuan

Beyond the basic medical insurance cap line above the cost, by the serious illness Medicaid appropriate solution. Employees of enterprises participate in Medicaid for major diseases, and the payment rate is 0.26% of the average salary of employees in the previous year, that is, individuals pay 4. 1 yuan per month, mainly to solve the medical expenses that the expenses of specific items of personal hospitalization and outpatient service exceed the top line by more than 75,800 yuan within one year. 90% ~ 95% of the expenses exceeding the "cap" can be solved by Medicaid for major diseases, and the cumulative maximum payment for one year is about 6.5438+0.5 million yuan, which is equivalent to raising the "cap line" to about 240,000 yuan.

Supplementary medical insurance for four projects

Conditional enterprises can participate in supplementary medical insurance to reduce the burden of employees' out-of-pocket expenses. There are four supplementary medical insurances in Guangzhou, namely, inpatient, outpatient chronic diseases, outpatient specific items and personal account supplementary insurance. If employees of enterprises participating in supplementary medical insurance are hospitalized for more than two times during the year, the payment standard can be reduced by1/4 ~1/2; 70% of out-of-pocket medical expenses are paid by supplementary insurance funds, and the proportion of payment is increased from 80% to 90% to 94% to 97% respectively. 70% of outpatient expenses above the deductible for chronic diseases such as coronary heart disease, diabetes and hypertension in the elderly. They are all paid by the supplementary insurance fund, and the annual cumulative maximum payment limit is 47,000 yuan.

National civil servants can enjoy Medicaid.

Organs and fully funded institutions implement the national civil service Medicaid. The Medicaid plan for civil servants in ordinary countries is basically the same as the supplementary medical insurance plan for enterprises, in order to implement the spirit of the national policy of not lowering the reasonable medical security level for civil servants.

Medical care for special groups

According to the new regulations, the insured can choose any designated general hospital, specialized hospital or Chinese medicine medical institution for medical treatment at any time according to his wishes. After seeing the disease, outpatients can get medicine from the hospital pharmacy, or they can buy medicine from the designated pharmacy with a prescription.

In the reform of medical insurance system, the state attaches great importance to the medical treatment of special groups and makes clear provisions on the medical treatment of relevant personnel. Mainly: First, the original treatment of retired cadres, the old Red Army and disabled revolutionary soldiers above Grade B will remain unchanged. Second, the care policy for medical staff such as cadres at or above the deputy department level remains unchanged. Third, retirees participate in basic medical insurance and enjoy three aspects of care: individuals do not pay fees; Personal accounts count more than employees; The proportion of individual pays within the deductible line and the scope of overall fund payment are lower than those of on-the-job employees. Fourth, laid-off workers are paid locally by the re-employment service center at the rate of 60% of the average salary of local workers, and enjoy the same basic medical insurance benefits as on-the-job workers.