1. The payment rate for medical insurance for urban employees: 1. Persons participating in the insurance as a unit: The unit payment rate is 8% of the payment base (the payment base shall not be less than 60% of the average monthly salary of employees in the province in the previous year.)

%, the personal contribution rate is 2% of the payment base, and retirees do not pay.

2. Flexibly employed persons participating in the insurance as individuals: pay basic medical insurance premiums based on 6% of the average monthly salary of employees in the province in the previous year.

2. The minimum payment standard and maximum limit of the overall planning fund 1. The minimum payment standard for employees is 800 yuan; for retirees, the minimum payment standard is 600 yuan.

When you enjoy the benefits of medical expenses paid by the unified fund again that year, the minimum payment standard will no longer be implemented.

2. At present, the annual cumulative maximum payment limit of the provincial overall fund is 260,000 yuan.

However, for medical expenses incurred due to major diseases, such as acute leukemia (bone marrow transplant), liver transplant, and kidney transplant, the overall fund will pay a maximum annual payment of 500,000 yuan in the year of transplant surgery.

3. The annual expenses are accumulated based on the time of discharge to determine the settlement year.

3. The proportion of medical expenses reimbursed by the basic medical insurance for employees 1. The reimbursement proportion of medical expenses above the minimum payment standard and below the maximum payment limit for employees is: 90% for medical treatment in first-level medical institutions; 88% for medical treatment at second-level medical institutions

%; 85% reimbursement for medical treatment in tertiary medical institutions.

2. Retirees will pay 90% from the overall fund and 10% from the individual.

However, the following conditions must be met: 1. Those who receive pensions on a monthly basis in Hainan Province, 2. Those who have participated in basic medical insurance while working, 3. The payment period (including deemed deemed) is more than 30 years for men and 25 years for women.

(For those who have not reached the payment period, the basic medical insurance benefits they enjoy will be reduced by 3% for each year reduced).

4. Conditions for participating in employee medical insurance to enjoy overall payment benefits: 1. After participating in basic medical insurance, the insured must have paid continuously for one year before they can enjoy the overall fund payment benefits.

If payment is interrupted for 3 consecutive months or if payment is stopped for 6 months cumulatively, the basic medical insurance benefits will be stopped.

After resumption of payment, if the payment has been interrupted for 3 consecutive months, the unified fund payment benefits can be enjoyed again after 6 consecutive months of continuous payment; if the payment has been interrupted for 6 months in total, the unified fund payment can only be enjoyed again after 1 year of continuous payment.

.

2. Retirees who participate in employee medical insurance will enjoy corresponding medical treatment according to the cumulative payment years (including deemed payment) in accordance with the "Regulations".

If the cumulative payment years are not enough, you can also make a one-time supplementary payment in accordance with the relevant provisions of Article 27 of the "Regulations".

3. Retirees who have never participated in basic medical insurance can enjoy the corresponding basic medical insurance benefits after paying 10 years of basic medical insurance compensation in one lump sum and the next month after paying according to regulations.

4. During the period of receiving unemployment insurance benefits, unemployed persons shall pay basic medical insurance premiums from the unemployment insurance fund and enjoy basic medical insurance benefits for employees.

5. All basic medical insurance paid by flexible employment personnel participating in basic medical insurance will be transferred to the overall fund.

Before retirement, you will enjoy overall fund benefits, and after retirement, you will enjoy individual account benefits and overall fund benefits.

6. Personal account crediting method 1. All 2% of the basic medical insurance premiums paid by working personnel who are insured as units are transferred into the overall fund + the amount transferred into the overall fund according to different age groups (currently 6 yuan for those under 30 years old in our province, 40 yuan for those under 30 years old)

9 yuan for those under 50 years old, 14 yuan for those under 50 years old, and 20 yuan for those under 60 years old).

2. The monthly amount credited to the personal account of retirees who fully enjoy basic medical insurance is: 60 yuan for those under 70 years old and 72 yuan for those over 70 years old. If the accumulated payment years are insufficient, the amount will be reduced by 3% for each missing year.