There is no difference between urban medical insurance and residents’ medical insurance. They are the same. They are also called urban residents’ basic medical insurance.

Urban residents’ medical insurance is a medical insurance system that mainly covers urban minors and unemployed residents who have not participated in urban employee medical insurance. It is a major measure taken by the Party Central Committee and the State Council to further solve the medical security issues of the broad masses of the people and continuously improve the medical security system, following the implementation of the basic medical insurance system for urban employees and the new rural cooperative medical system.

Urban residents’ medical insurance mainly makes institutional arrangements for urban non-employed residents’ medical insurance. The emergence of this system is of great significance in the process of China's social insurance system reform and points out the direction of China's social insurance system reform.

Extended information:

The functions of urban medical insurance:

1. The urban resident basic medical insurance fund is mainly used to pay for hospitalization and outpatient serious illness of insured residents. , outpatient rescue medical expenses, the payment scope and standards shall be implemented in accordance with the urban residents basic medical insurance drug catalog, diagnosis and treatment items and medical service facilities scope and standards.

2. The minimum payment standard (also commonly referred to as the threshold fee) is the same as the urban employee basic medical insurance, that is, 980 yuan for the third level, 720 yuan for the second level, and 540 yuan for the first level.

3. Medical treatment management: Residents insured by the Urban Resident Basic Medical Insurance shall implement a designated first consultation and two-way referral system for medical treatment, integrating community health service centers, specialist hospitals, hospital-store cooperation and secondary and lower medical treatment Institutions are identified as first-diagnosis medical institutions, and some tertiary comprehensive and specialist medical institutions are identified as designated referral medical institutions.

Insured residents should first seek medical treatment at a designated first-diagnosis medical institution. If their condition truly requires transfer to a hospital for treatment, the designated first-diagnosis medical institution must issue a transfer certificate before they can be transferred to a designated referral hospital. After receiving inpatient treatment, the patient should be transferred back to the designated first-diagnosis hospital after the condition is relatively stable.

4. Payment ratio. The fund payment ratio is determined according to different levels of medical institutions. The fund payment ratios of first-level (including community health service centers), second-level, and third-level medical institutions are 75%, 60%, and 50 %. After urban residents have continuously participated in insurance and paid contributions for two years, they can be increased to 80%, 65%, and 55% respectively. (In other words, the smaller the hospital you stay in, the more you will be charged).

5. Basic insurance amount. Within a natural year, the maximum payment limit of the basic medical insurance pooling fund is 16,000 yuan per person per year.

Baidu Encyclopedia-Urban Residents Basic Medical Insurance

Baidu Encyclopedia-Urban Residents Medical Insurance