The principle of medical treatment is different: the first insured: any designated medical institution in the city for medical treatment. Second-class insured persons: outpatients seek medical treatment in the binding community health center, inpatient departments seek medical treatment in any designated medical institutions in the city, and outpatients seek medical treatment in designated medical institutions for serious illness.
General outpatient treatment is different: first class insurance: personal account is used to pay medical expenses within the scope of the insured's general outpatient medical insurance catalogue. Community health center basic medical expenses personal account to pay 70%, the overall fund to pay 30% in accordance with the provisions. Class II insured persons: those belonging to Class A drugs and Class B drugs shall be paid by the community outpatient co-ordination fund according to the proportion of 80% and 60% respectively; 90% of the single diagnosis and treatment or medical materials belonging to the medical insurance catalogue shall be paid by the community outpatient co-ordination fund, but the maximum payment amount shall not exceed 120 yuan; The total outpatient medical expenses paid by the community outpatient co-ordination fund to each second-grade and third-grade insured within a medical insurance year shall not exceed 1000 yuan.
Legal basis: People's Republic of China (PRC) Social Insurance Law.
Article 1 This Law is formulated in accordance with the Constitution for the purpose of adjusting the social insurance relationship, safeguarding citizens' legitimate rights and interests in participating in social insurance and enjoying social insurance benefits, enabling citizens to enjoy the fruits of development and promoting social harmony and stability.
Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.
Article 3 The social insurance system adheres to the principles of wide coverage, basic protection, multi-level and sustainability, and the level of social insurance should be compatible with the level of economic and social development.
Article 4 Employers and individuals who pay social insurance premiums according to law in People's Republic of China (PRC) have the right to inquire about payment records and personal rights and interests records, and ask social insurance agencies to provide social insurance consultation and other related services.
Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.
Fifth people's governments at or above the county level shall incorporate social insurance into the national economic and social development plan. The state raises social insurance funds through multiple channels. People's governments at or above the county level shall give necessary financial support to social insurance.
The state supports social insurance through preferential tax policies.