First, the basic medical insurance payment base
1. Employee: The salary base is based on my average salary last month. Last year, the average monthly salary of employees was lower than 60% of the average monthly salary of employees in this Municipality in the previous year, and 60% of the average monthly salary of employees in this Municipality in the previous year was the base of payment, and the basic medical insurance premium was paid; Last year, the average monthly salary of employees was higher than the average monthly salary of employees in this city by more than 300%, which was not used as the base of payment of wages and did not pay the basic medical insurance premium; If it is impossible to determine the average monthly salary of employees in the previous year, the average monthly salary of employees in this city in the previous year shall be the base of payment salary and the basic medical insurance premium shall be paid.
2. Employer: The sum of the salary bases paid by all employees is taken as the salary base for the unit to pay the basic medical insurance.
Two, the basic medical insurance premium payment ratio
1. Employees: pay the basic medical insurance premium at 2% of their salary base. Transfer to employee's personal account.
2. Employer: Pay the basic medical insurance premium at 9% of the wage base paid by the employer.
The insurance premium paid by the employer is included in the employee's personal account according to the following standards:
(a) employees under the age of 35, according to my monthly salary base included in personal accounts;
(2) Employees over the age of 35 and under the age of 45 shall be transferred to personal accounts at 1% of their monthly salary base;
(three) employees over the age of 45, according to my monthly salary base of 2% included in the personal account;
(four) retirees under the age of 70, according to the average monthly salary of employees in this city in the previous year included in the personal account; (five) retirees over the age of 70, according to the average monthly salary of employees in this city in the previous year included in the personal account.
Three. Basic medical insurance benefits
1, personal account pays the following medical expenses:
Outpatient and emergency medical expenses;
(two) the cost of purchasing drugs in designated retail pharmacies;
(three) the basic medical insurance fund Qifubiaozhun below the medical expenses;
(four) medical expenses that exceed the deductible line of the basic medical insurance pooling fund and should be borne by individuals in proportion. The insufficient part of personal account shall be paid by myself.
2, the basic medical insurance fund to pay the following medical expenses:
(a) hospitalization expenses;
(two) emergency rescue and hospitalization, medical expenses incurred within 7 days before hospitalization;
(three) outpatient medical expenses for taking anti-rejection drugs after radiotherapy and chemotherapy, renal dialysis and renal transplantation for malignant tumors.
3, the basic medical insurance fund payment Qifubiaozhun according to the average wage of workers in this city last year 10% or so. The medical expenses incurred by an individual in hospitalization for the second time or later in a year, the Qifubiaozhun is determined according to about 5% of the average salary of employees in this city in the previous year.
4, the basic medical insurance fund in a year to pay employees and retirees medical expenses of the cumulative maximum payment limit according to the city's average wage of workers in the previous year about 4 times to determine.
The above is the knowledge about the base of medical insurance payment, I hope it will help you.