Medical care, medical insurance, NCMS trinity

Reimbursement differences: The new rural cooperative medical system (hereinafter referred to as "NCMS") is a mutual medical assistance system for farmers based on the overall planning of serious diseases, and the basic medical insurance for urban employees is a social insurance system established to compensate workers for economic losses due to disease risks.

The new type of rural cooperative medical care (hereinafter referred to as "NCMS") refers to the system of mutual medical assistance and mutual aid for farmers, which is organized, guided and supported by farmers, voluntarily participated by farmers, and financed by individuals, collectives and parties. It raises funds in the form of individual payment, collective support and funding.

The basic medical insurance for urban employees is one of the components of China's medical insurance (medical insurance for urban employees, medical insurance for urban residents, and new rural cooperative medical care), which is a social insurance system established to compensate workers for economic losses due to the risk of disease.

At the same time, the new rural cooperative medical care of the health system and the urban residents' medical insurance of the human resources and social security system are merged into the "medical insurance for urban and rural residents", which implements unified payment, unified management, unified accounting, and unified reimbursement, and does not merge with the medical insurance for enterprise employees. Therefore, resident medical insurance and employee medical insurance are still different medical insurance systems, with different contributions, different reimbursement catalogs, different reimbursement ratios, and different reimbursement starting points.

Because the medical insurance is coordinated at the municipal level, the medical insurance payment and reimbursement in each region are slightly different, and the specific details can be called 12333 human resources and social security services** for consultation.

6.It is mandatory for employees to pay social insurance, and NCMS is not mandatory, but depends on the willingness of the individual.

Medical insurance and NCMS are two different medical insurance systems. Medical insurance is mainly aimed at urban residents and enterprise employees (resident medical insurance and employee medical insurance), and the ratio of employee medical insurance is generally higher than that of resident medical insurance. NCMS is a medical system mainly for the rural population.

In general, the cost of NCMS banquets is much lower than that of employees' medical insurance. In general, the ratio of local medical insurance is that the medical insurance for employees is greater than that of the NCMS, which is equivalent to the medical insurance for residents. The specific reimbursement rates are formulated by the relevant local departments, which are closely related to the economic development of Dangyan Yindi.

The differences between medical insurance and NCMS are as follows:

1. Different groups of people:

1) The full name of NCMS is a new type of rural cooperative medical care, in which farmers contribute some money per person every year, and the state subsidizes some money, and the basic medical insurance system is jointly established. You must have a rural hukou to participate in NCMS. The target group is farmers who do not work in cities and towns;

2) Medical insurance is the basic medical insurance for urban employees, which is not limited to household registration, and is composed of individual payment and overall payment. The main target group is working workers and flexible workers;

2. Different payment methods:

1) The new farmer pays once a year, and the individual pays for it;

2) Medical insurance is usually paid on the first day of January, and the unit bears the overall part. Individuals with flexible employment are required to bear part of the overall contributions;

3. Different treatments:

1) The agricultural cooperative system is mainly aimed at farmers, with low payment and low reimbursement amount, with a proportion of about 50%;

2) Medical insurance is mainly for employees and flexible employees, with high payment and high treatment, and the reimbursement ratio is about 90%;

4. Different retirement ages:

1) After reaching the retirement age and meeting the requirements of the local medical insurance retirement period, the urban employees can retire by medical insurance and enjoy free medical insurance treatment for life;

2) NCMS has no retirement policy and pays for life.

Legal basisArticle 20 of the Social Insurance Law of the People's Republic of China.

The State shall establish and improve a new type of rural social endowment insurance system.

The new rural social endowment insurance implements a combination of individual contributions, collective subsidies and subsidies.

Article 21.

The new rural social endowment insurance benefits are composed of basic pensions and personal account pensions.

Rural residents who participate in the new rural social endowment insurance and meet the conditions stipulated by the state shall receive the benefits of the new rural social endowment insurance on a monthly basis.

1. The people covered are different.

The medical insurance for urban and rural residents covers residents who do not work and urban minors who do not participate in the medical insurance for urban employees;

The main target of NCMS is rural farmers.

2. The degree of protection is different.

The starting line of medical insurance for urban and rural residents is higher than that of NCMS, and the reimbursement ratio in large hospitals is also higher than that of NCMS. The reimbursement cost of NCMS in township health centers is relatively high;

The payment for medical reimbursement for urban and rural residents is paid every month, with a maximum reimbursement of 70%, and the NCMS is paid once a year, with a maximum reimbursement of 30%.

3. It is the different departments of management.

Medical insurance for urban residents is mainly managed by the human resources and social security departments, and most places in NCMS are managed by the health departments.

4. The focus of the guarantee treatment is different.

The medical insurance for urban residents mainly covers both inpatient and outpatient serious illnesses and ordinary outpatient services, so the treatment of inpatient and outpatient serious illnesses is higher than that of NCMS. The level of outpatient treatment of NCMS is higher than that of urban residents' medical insurance.

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Medical insurance includes NCMS, and the difference between medical insurance and NCMS generally refers to the difference between employee medical insurance and NCMS, mainly including the following differences:

1. The payment method is different. Employee medical insurance needs to be paid monthly, which is a compulsory insurance and is paid by the employer. When an individual works in the company, the company has the obligation to pay medical insurance for the employees, and when the employee leaves the company, he can bring his ID card to the local social security bureau to pay the medical insurance.

The new farmer only needs to pay once a year, and does not need to pay every month.

2. The time of payment is different. Employee medical insurance can be paid every month, if the employee medical insurance is interrupted, when the payment is more than three months, it will affect the medical security, and the supplementary payment can be made within three months. NCMS is paid on an annual basis, and the annual payment time is from the beginning of November to the end of December, and the special payment time will be clearly stipulated.

3. The fees paid are different. The employee medical insurance will be calculated with reference to the average salary of local employees in the previous year, and the fees paid are much higher than those of NCMS. In 2022, the annual fee for the payment of NCMS in Hubei is 320 yuan, and the regulations on the payment of NCMS in each region are different, subject to the actual situation.

4. The proportion of reimbursement is different. The proportion of reimbursement for employee medical insurance is relatively high, usually more than 70%. However, the reimbursement rate of NCMS is relatively low, and the maximum reimbursement shall not exceed 50%.

There are three kinds of differences between medical insurance and NCMS, and the specific differences are as follows:

1. The payment subject is different. Medical insurance is paid by urban workers, and rural cooperative medical care is paid by farmers;

2. The cost is different. Medical insurance is compulsory and is charged according to a certain proportion of employees' wages, and rural cooperative medical care is voluntarily participated by farmers, and the cost is generally fixed;

3. Different payment methods. The medical insurance is paid by the unit and the employee together, and the unit pays most of it, and the employee only pays a small part. Rural cooperative medical care is paid by the farmers themselves.

According to Article 23 of the Social Insurance Law of the People's Republic of China, employees shall participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state. Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

Article 24: The State is to establish and improve a new type of rural cooperative medical system. The management measures for the new type of rural cooperative medical care shall be stipulated by ***. Article 25 The State shall establish and improve the basic medical insurance system for urban residents.

The basic medical insurance for urban residents implements a combination of individual payment and subsidy. Those who enjoy the minimum living guarantee, the disabled who have lost the ability to work, the elderly over the age of 60 and minors from low-income families, etc., will be subsidized by **. Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with the provisions of the State.

Legal basisArticle 23 of the Full Text of the Social Insurance Law of the People's Republic of China Employees shall participate in the basic medical insurance for employees, and the employer and the employees shall jointly pay the basic medical insurance premiums in accordance with the provisions of the State. Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

The differences between medical insurance and agricultural insurance are as follows:

1. The concept is different.

Social health insurance is also known as "sickness social insurance" or "health social insurance". It is a kind of social insurance in which the insured organization provides material assistance for the interruption of income and the loss of medical expenses due to illness, injury, disability, etc.

The new type of rural cooperative medical care refers to the system of mutual medical assistance and mutual aid for farmers that is organized, guided and supported, voluntarily participated by farmers, raised by individuals, collectives and multiple parties, and is mainly based on the overall planning of serious diseases. It raises funds in the form of individual payment, collective support and funding.

2. The insured objects are different.

Rural cooperative medical care refers to the fact that all rural residents who are registered in the place and are born after 90 days and urban residents who have not participated in the basic medical insurance for urban employees can participate, and rural residents who have not participated in the basic old-age insurance for urban employees can voluntarily participate in the insurance in the place of household registration. Medical insurance is paid by oneself and partly by the company.

3. The payment fee and method are different.

The cost of rural medical insurance is several hundred yuan a year, while the cost of social security payment is thousands or even tens of thousands a year, compared with the cost of rural medical insurance, which is much lower. Rural medical insurance is fully covered by the insured, while social insurance is borne by the employee and the company.

The medical insurance for urban employees is paid on a monthly basis and the minimum payment period is established, and if the payment period (25 years for men and 20 years for women) is reached, they can enjoy the basic medical insurance treatment after retirement. The new type of rural cooperative medical care is paid annually and for life, and no payment is not enjoyed.