Of the unit contributions, 30% is transferred to individual accounts, and the remaining 70% is used to co-ordinate the fund to pay medical expenses such as hospitalization expenses and outpatient special diseases. The source of funds for personal accounts also includes personal contributions, that is, 2% of wages. In addition, in addition to individual contributions, the sources of funds in the personal accounts of retirees also include the monthly subsidies, subsidies and benefits paid by retirees and the one-time medical insurance premiums included in personal accounts.
Employee medical insurance processing flow:
1. After the employee joins the company, the company will submit the employee's personal information and medical insurance payment information to the local social insurance agency within the specified time to handle the medical insurance registration for the employee;
2. Employees hold valid identity documents and personal medical insurance cards to the local social insurance agencies to handle the activation and collection procedures of medical insurance cards, and at the same time understand the local medical insurance policies and reimbursement standards;
3, employees and units in accordance with the provisions of the medical insurance payment ratio to pay medical insurance fees;
4. When employees need medical treatment, they should go to the medical institutions designated by medical insurance for treatment, pay the expenses paid by individuals, and receive medical bills and other related materials;
5. Employees should prepare reimbursement application materials (such as medical bills, expense lists, diagnosis certificates, etc.). ) and apply for medical insurance reimbursement at the local social insurance agency;
6 agencies to review the application materials for reimbursement, verify the proportion and amount of reimbursement, and the reimbursement will be credited to the employee medical insurance card account.
To sum up, the balance in the medical insurance account can only be used to pay medical expenses within the scope of medical insurance and cannot be used for other purposes.
Legal basis:
Article 27 of People's Republic of China (PRC) Social Insurance Law
Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.