Units and employees in the basic medical insurance at the same time, each insured person and unit should pay a large amount of medical subsidies to the social insurance agencies to pay the insured person's medical expenses over the top line.
The large medical expenses subsidy for employees is a medical subsidy method adopted by various localities to solve the large medical expenses above the capping line in the process of promoting the reform of the basic medical insurance system. With the establishment of basic medical insurance, this method is enforced by the local government among the insured workers and handled by the local social insurance agency, which belongs to a kind of social supplementary insurance. Insurance premiums are generally raised by each employee paying a certain fee every year. Social insurance agencies set up large medical expenses subsidies, which are managed and accounted for separately from the basic medical insurance fund. The medical expenses incurred by the insured workers above the capping line shall be paid by a large amount of medical expenses subsidies according to a certain proportion.
legal ground
People's Republic of China (PRC) social insurance law
Article 38 The following expenses incurred due to work-related injuries shall be paid by the work-related injury insurance fund in accordance with state regulations:
(a) medical expenses and rehabilitation expenses for the treatment of work-related injuries;
(2) Hospitalization food subsidies;
(three) transportation and accommodation expenses for medical treatment outside the overall planning area;
(four) the cost of installing and configuring assistive devices for the disabled;
(five) life can not take care of themselves, confirmed by the labor ability appraisal committee of life care costs;
(6) One-time disability allowance and monthly disability allowance for disabled employees of Grade I to IV;
(seven) the one-time medical subsidy that should be enjoyed when the labor contract is terminated or dissolved;
(8) Funeral grants, dependent relatives' pensions and work-related death grants received by survivors of work-related deaths;
(nine) labor ability appraisal fee. Article 39 The following expenses incurred due to work-related injuries shall be paid by the employing unit in accordance with state regulations:
(a) wages and benefits during the treatment of work-related injuries;
(two) the monthly disability allowance for disabled employees of Grade 5 and Grade 6;
(3) One-time disability employment subsidy that should be enjoyed when the labor contract is terminated or dissolved.