Sichuan medical insurance payment ratios are as follows:
Medical insurance payment ratios for unit employees:
1. Urban employees: 6.5% for employers and 2% for individuals;< /p>
2. Workers registered in this city who were formerly covered by comprehensive insurance: 6.5% for employers, 2% for individuals;
3. Migrant workers not registered in this city: 2.5% for employers, no need for individuals Pay.
Resident medical insurance payment ratio:
1. College students/primary and middle school students and infants: 70 yuan per person per year;
2. Adult residents: per person 80 yuan per year or 180 yuan per person per year;
3. Adult residents of Jinjiang District, Qingyang District, Jinniu District, Wuhou District, Chenghua District, High-tech Zone and qualified districts (cities) and counties are paid on an individual basis The standard financing standard is 180 yuan per person per year;
4. The payment standard for resident critical illness mutual aid supplementary insurance: there are two payment standards: 150 yuan and 300 yuan per person per year.
Social medical insurance is a medical insurance system enforced by the state through legislation. Employers and individuals pay insurance premiums in a certain proportion, establish a social medical insurance fund, and pay employees' medical expenses.
Social medical insurance means that when workers fall ill, social insurance institutions provide appropriate subsidies or reimbursement for the medical expenses they need, so that workers can restore their health and working ability and participate in the social reproduction process as soon as possible.
Social medical insurance is an important part of social insurance and is generally undertaken by the government. The government will use economic means, administrative means, and legal means to enforce and organize management.
Account establishment
The social medical insurance agency establishes a basic medical insurance personal account for each insured person, and uses the personal ID number as the lifelong medical insurance number.
The funds in the personal account of the basic medical insurance for employees belong to the individual and are used exclusively for medical consumption. Overexpenditures will not be reimbursed, the balance will be rolled over, and cash withdrawals are not allowed. When an employee dies, the personal account will be canceled and the balance will be inherited according to regulations.
Settlement and issuance
The employer shall apply for a personal medical account settlement card for its employees while participating in the basic medical insurance. For employees who are newly enrolled in medical insurance, the employer shall submit an application to the social medical insurance agency within 30 days from the date of enrollment and provide relevant information. After receiving the employer's application for establishing an employee account, the social medical insurance agency shall carefully review the relevant information, establish a personal account for the employee within 15 days, and issue a personal account settlement card.
Inject funds into employees’ personal medical accounts in a timely manner and calculate interest in accordance with relevant regulations. Retirees who are resettled in other places may not be issued cards temporarily.
Insured persons can use their personal medical account cards to seek medical treatment and purchase medicines at any designated medical institution and designated pharmacy in the coordinated area. When personal medical account funds are insufficient, payment is made in cash.
Transfer and Inheritance
Insured personnel will be transferred away from the local area, and the personal medical account funds will be transferred with them. If the transfer cannot be done, the personal account balance will be refunded to the individual and the personal account will be canceled at the same time.
If the insured person dies, the balance of the personal account can be inherited by his legal heirs.
Report loss and reissue
Insured persons should properly keep their personal account cards. If the card is damaged and needs to be replaced with a new one, the cost shall be borne by the individual. If the personal account card is lost, you should promptly report the loss to the medical insurance agency or designated unit with the relevant documents, and the medical insurance agency should seal the account immediately. If the card cannot be found within 30 days, you should apply for a new card at your own expense.
The personal account portion of the medical expenses incurred during the period of loss reporting shall be paid by the employee’s personal cash. If the personal account card is used fraudulently before going through the loss reporting procedures, the loss will be borne by the insured person.
When the insured person uses the card to seek medical treatment, purchase medicine and settle medical expenses, the service staff of designated medical institutions and pharmacies should carefully check. If a card is found to be forged or fraudulently used, the card should be detained immediately and the social medical insurance manager should be notified. office. Designated medical institutions and pharmacies are not allowed to refuse card funds and are not allowed to exchange cash for card holders.