Minimum payment base of medical insurance

(1) Employees: The salary base is based on my average salary in the previous month. If the average monthly salary of employees in the previous year is lower than 6% of the average monthly salary of employees in this city in the previous year, 6% of the average monthly salary of employees in this city in the previous year shall be the base of payment of wages, and the basic medical insurance premium shall be paid; The part where the average monthly salary of employees in the previous year was higher than the average monthly salary of employees in this city by more than 3% in the previous year will not be used as the base for payment of wages and will 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 shall be taken as the salary base for the unit to pay the basic medical insurance.

basic medical insurance premium payment ratio

(1) employees: pay the basic medical insurance premium at 2% of the salary base of their own contributions. Transferred to the employee's personal account. (2) Employer: Pay the basic medical insurance premium at 9% of the salary base paid by the employer.

Part of the insurance premium paid by the employer is credited to the employee's personal account according to the following criteria:

1. Employees under the age of 35 are credited to the personal account according to .8% of their monthly salary base;

2. Employees over 35 years old but under 45 years old shall be transferred to individual accounts according to 1% of their monthly salary base;

3. Employees over the age of 45 are credited to individual accounts according to 2% of their monthly salary base;

4. Retirees under the age of 7 will be credited to individual accounts according to 4.3% of the average monthly salary of employees in this city in the previous year;

5. Retirees over the age of 7 will be credited to individual accounts according to 4.8% of the average monthly salary of employees in this city in the previous year.

Basic medical insurance benefits

(1) Personal accounts pay the following medical expenses:

1. Medical expenses for outpatient and emergency treatment;

2. The cost of purchasing medicines at designated retail pharmacies;

3. Medical expenses below the Qifubiaozhun of the basic medical insurance pooling fund;

4. medical expenses that exceed the threshold of the basic medical insurance pooling fund and should be borne by individuals in proportion. The insufficient part of the personal account is paid by myself.

(2) The basic medical insurance fund pays the following medical expenses:

1. Medical expenses for hospitalization;

2. The medical expenses within 7 days before the emergency rescue observation and hospitalization;

3. outpatient medical expenses of radiotherapy and chemotherapy for malignant tumor, renal dialysis and taking anti-rejection drugs after renal transplantation.

(3) The minimum payment standard for the basic medical insurance co-ordination fund is determined by about 1% of the average salary of employees in this city in the previous year. The qifubiaozhun for the medical expenses incurred by an individual in hospitalization for the second time and later in a year is determined by about 5% of the average wage of employees in this city in the previous year.

(4) The cumulative maximum payment limit of medical expenses paid by the basic medical insurance pooling fund to employees and retirees in one year is determined by about 4 times of the average salary of employees in this city in the previous year.

Legal basis:

the State Council's Decision on Establishing the Basic Medical Insurance System for Urban Workers

III. Establishment of Basic Medical Insurance Co-ordination Fund and Personal Account

Basic Medical Insurance Co-ordination Fund and Personal Account should be established. The basic medical insurance fund consists of overall funds and individual accounts. The basic medical insurance premiums paid by individual employees are all included in individual accounts. The basic medical insurance premium paid by the employer is divided into two parts, one part is used to establish the overall fund and the other part is included in the personal account. The proportion of individual accounts is generally about 3% of the contributions paid by the employer, and the specific proportion is determined by the overall planning area according to the payment scope of individual accounts and the age of employees.