District-directed medical insurance 1. Basic medical insurance benefits (1) Sources of personal account funds 1. Basic medical insurance premiums paid by individual employees, 2% of their total wages, are all transferred to their personal accounts.

2. The basic medical insurance premium paid by the employer is 8% of the total salary (6% in 2002), and the specified part is transferred to the personal account. The specific allocation method is 0.5% for those aged 45 and below; 1% for those aged 46 to 59; 60

1.5% for those aged 1.5 years and above.

(2) Sources of the overall pooling fund: The basic medical insurance premiums paid by the employer shall be transferred to individual accounts in accordance with regulations, and the rest shall go into the basic medical insurance pooling fund.

(3) Payment scope of personal accounts Personal accounts are mainly used to pay for outpatient medical expenses that comply with the basic medical insurance drug catalog and diagnosis and treatment items; to pay for medical expenses that should be paid by the individual for hospitalization; to pay for special examinations and special treatments and some outpatient chronic diseases

outpatient medical expenses.

(4) Payment scope of the overall fund 1. Payment of hospitalization medical expenses: Medical expenses incurred during hospitalization that comply with the provisions of basic medical insurance: above the minimum payment standard and below the maximum payment limit shall be paid by the overall fund according to the segmented accumulation method.

, individuals also have to pay a certain proportion: overall fund payment ratio % personal self-pay ratio % hospitalization medical expenses, on-the-job retirement, on-the-job retirement, minimum payment amount above 5,000 yuan, 707520155000-10000 yuan, 7580151.01 million yuan up to the maximum limit, 80851052, overall fund within one year

The maximum payment limit is four times the employee's annual salary. Medical expenses exceeding the maximum limit will no longer be paid by the unified fund. Insured persons will pay in cash and will be settled through commercial medical insurance and other channels.

2. Interim Provisions on Medical Subsidy for National Civil Servants (1) Scope of Subsidy 1. Medical expenses and drug catalog that comply with basic medical insurance diagnosis and treatment items and medical service facility standards.

2. Part of the medical expenses exceeding the maximum payment limit of the basic medical insurance fund.

3. Individuals pay out-of-pocket medical expenses exceeding a certain amount within the payment scope of basic medical insurance.

4. Medical expenses incurred by medical caregivers when they receive medical care in accordance with regulations.

5. Work-related injuries and maternity medical expenses that are eligible for national civil servant medical subsidies.

(2) Outpatient medical subsidy complies with the provisions of basic medical insurance. If a one-time medical expense occurs: 55% subsidy for employed personnel (the total outpatient medical expense exceeds 1,600 yuan within one year) will no longer be subsidized.

65% of the subsidy for retirees (the total outpatient medical expenses in one year exceeds 1,800 yuan) will no longer be subsidized.

90% of the subsidy for medical care personnel (the total outpatient medical expenses in one year exceeds 2,000 yuan) will no longer be subsidized.

(3) Hospitalization subsidy 1. Inpatient bed fee subsidy: For the amount that exceeds the basic medical insurance bed fee by more than 15 yuan, the daily subsidy is: 10 yuan for working personnel, 15 yuan for retirees, and 25 yuan for medical care personnel.

2. The medical expenses incurred during hospitalization within one year, above the minimum payment standard and below the maximum payment limit of the basic medical insurance co-ordination fund, are borne by individuals, such as Class B drugs, Class B materials, Class B diagnosis and treatment items and segmented cumulative individual out-of-pocket expenses.

For part of the cost, the subsidy is: 85% subsidy for working personnel, 90% subsidy for retirees, 95% subsidy for medical care personnel, and 100% subsidy for health care recipients.

3. The subsidy for using drugs other than those listed in the basic medical insurance drug list during critical illness is: 50% subsidy for working personnel, 60% subsidy for retirees, and 90% subsidy for medical caregivers.

The subsidy method is that the doctor fills out an application form, submits it to the medical insurance center for approval, and then settles the bill in cash. The patient must bring the hospitalization invoice and application consent form to the medical insurance center for reimbursement according to regulations.

3. Medical treatment for some outpatient chronic patients 1. The diseases listed as outpatient chronic diseases include: coronary heart disease, diabetes, various malignant tumors, chronic obstructive emphysema, hypertension, Parkinson's syndrome, and decompensated liver cirrhosis.

Stage, uremia stage, chronic heart failure, anti-rejection immune modulation treatment after organ transplantation.

2. Each insured person can declare up to 3 diseases.

3. According to regulations, outpatient chronic diseases can only enjoy the drugs on the medical insurance drug list within the scope of the chronic disease.

4. Before entering the chronic disease subsidy, individuals must pay the drug expenses below the standard out of pocket, that is, 8% of the average annual salary of employees, and the remaining drug expenses will be paid into the overall fund in proportion.

4. Payment ratio for special prosecution and special treatment items 1. According to regulations, for part of the special prosecution and special treatment, individuals first pay 40% of the cost, and the remaining cost is paid according to the proportion stipulated in the basic medical insurance. The individual payment part is subsidized according to the proportion and limit of civil servant subsidy.

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2. For the use of imported materials, individuals must first pay 50% in cash, and the remaining costs will be subsidized in accordance with the provisions of Article 1.