Medical insurance is an important part of China's social security system, which aims to provide basic medical security for the broad masses of the people. At present, China's medical insurance is mainly divided into two categories: employee medical insurance and resident medical insurance. This article will analyze the three major differences between employee medical insurance and resident medical insurance, and help you better understand the two medical insurance systems.
1. The insured objects are different.
1.Employee medical insurance: mainly for in-service employees working in employers, including enterprises, government agencies, public institutions, etc., as well as individual industrial and commercial households, flexible employees, etc. Employee medical insurance is paid by the employer for the employee, and the individual also needs to bear a certain percentage of the cost.
2.Resident medical insurance: Mainly for urban and rural residents who have not participated in employee medical insurance, including urban residents and rural residents. Resident medical insurance is paid by individuals, and a certain subsidy will be given.
2. The payment standards and treatment levels are different.
1.Employee medical insurance: the payment standard is relatively high, and the level of treatment is relatively high. The payment base of employee medical insurance is usually the salary income of the employee himself, and the contribution ratio is 8% (of which the employer bears 6% and the individual bears 2%). The reimbursement ratio of employee medical insurance is relatively high, and the reimbursement scope is wider, including hospitalization, outpatient, emergency, etc.
2.Resident medical insurance: the payment standard is low, and the level of treatment is relatively low. The payment amount of resident medical insurance is usually a few hundred yuan per year, and the specific amount is stipulated by the local government. The reimbursement ratio of resident medical insurance is low, and the reimbursement scope is narrow, mainly for hospitalization expenses.
3. Policy adjustments and implementation entities are different.
1.Employee medical insurance: The policy adjustment is relatively frequent, and the implementation subjects are employers and individual employees. The policy adjustment of employee medical insurance is usually the responsibility of the relevant departments, such as increasing the reimbursement ratio and lowering the starting line.
2.Resident medical insurance: The policy adjustment is relatively stable, and the implementation subject is **. The policy adjustment of residents' medical insurance is mainly responsible for the first department, such as raising the first subsidy standard and expanding the scope of reimbursement.
Summary: There are great differences between employee medical insurance and resident medical insurance in terms of insurance objects, payment standards and treatment levels, policy adjustments and implementation subjects. Understanding these differences can help us better choose the health care system that is right for you and ensure that you can receive timely medical care in the event of an illness. At the same time, we should also pay attention to the adjustment of medical insurance policies and keep abreast of relevant policies in order to better enjoy medical insurance treatment.