First, children's medical insurance

(1) coverage. All children registered in nurseries, kindergartens, primary schools, junior high schools, secondary schools, special schools, technical schools and vocational schools (excluding junior colleges) approved by the education, civil affairs, labor and social security departments of this Municipality shall participate in children's medical insurance: (1) Children who are not registered in this Municipality are participating in social insurance in this Municipality for more than one year when they apply for insurance; (2) children registered in this city under the age of 18 who have not entered the park, entered school or settled outside the city.

(2) payment standard. Each insured person pays 15 yuan every year, of which the guardian of the insured children pays 75 yuan and the financial subsidy is 75 yuan.

(3) scope of protection. The basic medical expenses incurred by the insured in hospitalization in the designated medical institutions of children's medical insurance, as well as the basic medical expenses for outpatient treatment of leukemia, hemophilia, aplastic anemia and malignant tumor after discharge in the designated medical institutions, and the basic medical expenses for outpatient dialysis treatment before renal transplantation and outpatient treatment of anti-rejection drugs after operation (hereinafter referred to as outpatient expenses for serious illness) are included in the scope of fund payment and enjoy the treatment of children's medical insurance as stipulated in the present Measures.

(4) time of enrollment. The insured shall go through the formalities of insurance and payment in September every year, and enjoy the treatment in that month. Newborns registered in this city shall go through the formalities of insurance and payment within 2 months from the date of birth, and the payment month shall be counted from the month of birth, and they shall enjoy the treatment from birth. If you apply for insurance at other times, you will pay the fee in the fourth month from the month of applying for insurance, and you will begin to enjoy the treatment in the month after paying the fee according to the regulations.

(5) deductible standard. Children's medical insurance is based on the standard system of hospitalization deductible line, including 3 yuan, a first-class hospital in the city, 4 yuan, a second-class hospital in the city, 5 yuan, a third-class hospital in the city, and 6 yuan, a hospital outside the city. (In the case of multiple hospitalizations in the same children's medical insurance year, the deductible for each hospitalization from the second hospitalization will decrease by 1 yuan in turn on the basis of corresponding standards until the deductible is zero. ) The outpatient expenses for serious illness are not deductible.

(6) medical treatment. If the basic medical expenses incurred by the insured above the deductible line for each hospitalization, or the basic medical expenses incurred for each serious illness clinic are within the annual maximum payment limit, the children's medical insurance fund will pay according to the following standards: 8% for the part below 5, yuan; 5 yuan to 1 yuan, children's medical insurance fund to pay 85%; More than 1 yuan, children's medical insurance fund to pay 9%.

(7) general outpatient service. The accumulated amount of individual account reaches the average monthly salary of employees in the previous year, and the excess can be used for the outpatient medical expenses of their children who have participated in children's medical insurance.

(8) Designated medical institutions. The city's 51

(9) annual maximum. (1) For those who have participated in children's medical insurance for less than one year in a row, the annual maximum payment limit of children's medical insurance fund is 1 time of the average annual salary of employees in the previous year; (2) For those who have participated in children's medical insurance for over 1 year but less than 2 years, the annual maximum payment limit of children's medical insurance fund is 2 times of the average annual salary of employees in the previous year; (3) For those who have participated in children's medical insurance for 2 years and less than 3 years, the annual maximum payment limit of children's medical insurance fund is 3 times of the average annual salary of employees in the previous year; (4) For those who have participated in children's medical insurance for 3 years and less than 4 years, the annual maximum payment limit of children's medical insurance fund is 4 times of the average annual salary of employees in the previous year; (5) For those who have participated in children's medical insurance for more than 4 years, the annual maximum payment limit of children's medical insurance fund is 2, yuan.

II. Overall medical care

(1) Insurance coverage. Longgang District belongs to the immediate family members of employees of party and government organs and institutions, and meets the following conditions, and can participate in overall medical care: children with local household registration, living in this city, under the age of 18, not yet employed, and living with their parents.

(2) payment standard. According to the standard of 7 yuan per person per year, the district finance pays the overall medical expenses for the immediate family members of the supernumerary employees, and the overall medical expenses for the family members of the supernumerary employees are raised by the unit according to the same standard. The administrative organs and institutions of the sub-district offices shall be implemented with reference to these measures.

(3) scope of protection. The medical expenses incurred by co-ordinating the hospitalization of medical objects in designated medical institutions of social medical insurance in Shenzhen, as well as the basic medical expenses (hereinafter referred to as outpatient expenses for serious illness) for outpatient blood transfusion, dialysis treatment for chronic renal failure, anti-rejection treatment after organ transplantation in designated medical institutions, chemotherapy, interventional therapy, radiotherapy or radionuclide therapy for malignant tumors, which are approved by Longgang Social Security Branch, are included in the payment scope of co-ordinating fund and enjoy the treatment of co-ordinating medical insurance as stipulated in the present Measures.

(4) time of enrollment. The object of overall medical care shall enjoy the overall medical treatment stipulated in these measures from the 1st of next month after being approved to participate in overall medical care.

(5) deductible standard. No

(6) medical treatment. 8% of the hospitalization basic medical expenses of the overall medical object are paid by the overall fund, and 2% are paid by the individual. Serious illness outpatient expenses paid by the overall fund 5%, the individual pays 5%.

(7) general outpatient service. 4 yuan as this year's outpatient expenditure subsidies to the families of workers, the street offices of administrative organs and institutions with reference to these measures.

(8) Designated medical institutions. See the website of Social Security Bureau for details.

(9) Annual ceiling. 1 thousand yuan.

Further reading: How to buy insurance, which is better, and teach you how to avoid these "pits" of insurance.