Judging from the average social index of our country, the lowest social security paying unit needs to pay 40%, the first level is 60%, the second level is 80%, and the third level is the highest, requiring 100%. The higher the payment level, the more expected it will be in the future.
The higher the pension amount, the choice of social security payment level mainly depends on your current economic situation.
The third level of basic medical care and the second level of basic medical care have an outpatient fee of 1,000 yuan per year, but they can only be enjoyed in bound social welfare hospitals. The first level of basic medical care can be used for outpatient services in all hospitals, but they all use the money from your own personal account.
When there is no money in the personal account, you need to pay cash; for the second and third levels of basic medical care, you can apply for 1,000 yuan per year. This money is from the overall fund, while the money for outpatient visits in the first level of basic medical care is your own money.
, only the money from the overall planning fund is reimbursed in the true sense.
The first level of basic medical care has the following three main advantages. First, if you have been continuously insured in the first level of basic medical care for more than 12 months, and the out-patient out-of-pocket expenses exceed 3,131 yuan in a medical year, 70% of the excess can be reimbursed.
Second, 30% can be reimbursed for outpatient visits in all social welfare hospitals. Third, 80% can be reimbursed for large-scale equipment inspections in outpatient clinics. This reimbursement is all from the unified fund. Otherwise, it is all from your own account.
money.
1. In terms of hospitalization, the benefits of basic medical treatment in the first level and basic medical treatment in the second level are the same, with a unified rate of 90%.
For example, all designated hospitals in Shenzhen can handle hospitalization directly, and the reimbursement rate is 90%.
The hospitalization reimbursement ratio of the third level of basic medical care is determined according to different levels of hospitals. In first-level hospitals, 85% can be reimbursed, second-level hospitals can reimburse 80%, and third-level hospitals can reimburse 75%. Insured persons in the third level must first arrive at the hospital when they are hospitalized.
For treatment in a designated social health hospital, you cannot directly go to other hospitals for hospitalization. You must issue a referral form through the bound hospital before you can go to the higher-level hospital of the bound hospital.
What are the differences between the first, second and third tiers of social security? 2. The main differences between social insurance and commercial insurance 1. Different implementation purposes Social insurance is to provide basic protection for social members when necessary and is not for profit; commercial insurance is an insurance company
Commercial operation for the purpose of profit; 2. Different implementation methods 3. Social insurance is compulsorily implemented in accordance with national legislation, while commercial insurance follows the principle of "freedom of contract" and is voluntarily insured by enterprises and individuals 4. Implementation subjects and objects are different in society
Insurance is raised, managed and issued by specialized institutions established by the state, and its targets are social members within the legal scope; commercial insurance is operated and managed by insurance companies, and the insured can be anyone who meets the underwriting conditions; 5
. Different levels of protection. The protection provided by social insurance to the insured is the most basic. Its level is higher than the social poverty line and lower than 50% of the average social wage. The level of protection is relatively low. The level of protection provided by commercial insurance completely depends on the insurance.
Depending on the agreement between the parties and the amount of premium paid by the policy holder, as long as they meet the insurance conditions and have a certain ability to pay, the insured can obtain a high level of protection.
Legal basis: Article 64 of the "Social Insurance Law of the People's Republic of China" stipulates that social insurance funds include basic pension insurance funds, basic medical insurance funds, work-related injury insurance funds, unemployment insurance funds and maternity insurance funds.
Each social insurance fund shall establish separate accounts according to the types of social insurance insurance, conduct separate accounting, and implement the unified national accounting system.
Social insurance funds are earmarked for exclusive use and may not be misappropriated or misappropriated by any organization or individual.
Basic pension insurance funds will gradually implement national pooling, and other social insurance funds will gradually implement provincial level pooling. The specific time and steps will be stipulated by the State Council.