Is there a difference between individual and unit insurance for medical insurance?

1. Different definitions:

1) Personal medical insurance refers to the use of various insurance tools to build their own medical security system, including social medical insurance and commercial medical insurance.

2) Unit medical insurance is a social insurance system established to compensate workers for economic losses caused by the risk of illness. Through the employer and individual payment, the establishment of medical insurance**, after the insured person is sick and incurs medical expenses, the medical insurance institution will give him a certain amount of economic compensation.

2. The amount of payment is different

1) Individuals pay social security, the general contribution ratio is 20%, and then refer to the local average salary and the payment grade provided by the social security department. The lowest grade is 60% and the highest grade is 300%.

2) The unit pays social security, the proportion of payment is part of the company, part of the individual, the pension insurance is 20% for you every month, and you pay 8% yourself; The medical insurance is 9% for you every month, and you pay 2% by yourself, plus 10 yuan for serious illness co-ordination.

3. Different insurance ages:

1) Individual insurance: The minimum insurance age generally ranges from 90 days after birth to 16 years old. The maximum issue age is about the same, at 65 years old.

2) The unit pays social security: the minimum insurance age is 16 years old, and the maximum insurance age is the statutory retirement age.

The reimbursement ratio for hospitalization is the same between those who are insured by individuals and those who are insured by units, and there is no big difference.

Personal account rebate, the insured personnel of the unit pay their own medical premiums every month are into the personal account, according to the minimum standard, each person has at least about 100 yuan;

To participate in the employee medical insurance as an individual, the first level does not have a personal account, and will not return money to the medical insurance account, and the second level will have a personal account to return money, about 100 yuan per month, and the personnel who participate in the first level can only apply for special diseases with four diseases, and the second level has 23 kinds;

On the whole, the first level has a low annual payment, no personal account, and the second level is basically the same as the medical insurance treatment paid by the unit.

As long as you are covered by insurance, there is no difference. But the process of enrolling in insurance is a bit different.

To help you enroll in the insurance in the name of the company, both the company and the individual have to pay a certain premium. If you are an individual, you will have to pay the full premium.

The premium is generally x% of salary, which varies from place to place, and you can check the local medical insurance regulations.

What is the difference between individual social security and unit social security?

The difference between individual social security and company social security is that individuals pay social security in full by themselves, while companies pay part of their own social security and the company pays part of it.

At present, China's medical insurance coverage has reached more than 90%, and everyone has their own medical insurance account. The emergence of medical insurance has reduced the burden of many people to see a doctor, especially for many people who are suddenly seriously ill but do not have any savings, which greatly reduces the cost pressure and allows everyone to have the opportunity to be treated. However, only those who pay medical insurance can enjoy the treatment of medical insurance, which is divided into individual medical insurance and unit medical insurance.

So, what is the difference between the contribution of individual and unit of individual medical insurance? A brief introduction to them is provided below.

1. Object-oriented is different

Personal medical insurance is mainly for people who do not have jobs, low-income households, students and children; The unit medical insurance is for people who have jobs or flexible employment, as well as individual industrial and commercial households.

Individual medical insurance is paid by the individual, and the financial subsidy is subsidized, and the amount of general financial subsidy is much more than that paid by the individual; The cost of medical insurance for the unit is borne by the unit and the individual, and the general proportion is 8% for the unit and 2% for the individual.

3. The payment standard method is different

Individual medical insurance is paid on an annual basis, there is a levy period, generally the next year's fee is paid in September to December each year, if you do not pay within the levy period, there will be a waiting period, during this period can not enjoy medical insurance. Unit medical insurance is paid on a monthly basis, generally stipulated that the payment is made before the number of each month, if the payment is overdue, there will be a late fee, and the medical expenses incurred during the unpaid period will not be reimbursed, and can only be reimbursed after payment.

4. Enjoy different treatments

The contribution of individual medical insurance is low, so the treatment is low, and the reimbursement ratio is about 45%-65%. The unit medical insurance is paid on time every month, and the treatment is higher, and the reimbursement ratio is about 70%-90%.

Medical insurance protects people's health and safety to a large extent, and there is no need to worry about the high cost, but when applying for medical reimbursement, it is still necessary to carefully understand the coverage of medical insurance. For some limitations of medical insurance, some commercial insurance can be used to complement each other to better protect health risks.

On the issue of medical insurance, individual contributions may be urban residents' medical insurance, or urban employees' medical insurance. The former is the same as that of ordinary people, and the latter pays much more than the unit. There is only one way to say that the employer pays the employee medical insurance, and it is required by law.

The employee pays a sum of money, and the unit pays a sum of money, and the overall cost is relatively small.

In addition, there is another difference, in many cases, the benefits of employee medical insurance are higher than those of resident medical insurance. Nowadays, many regular units will help employees buy five insurances and one housing fund, and after having a social security card, we can also inquire every month. Let's see how many grades it is, and whether you regularly send money to your social security card.

1. The type of insurance may be differentWhen individuals buy medical insurance, they are often urban resident insurance, that is, they buy it once a year, and they can be insured for one year at a time. Although there is also a medical insurance card, there is no personal account in it, and it is impossible to send money into it every month. When we are sick, due to the low contribution rate, the reimbursement ratio and scope will be less.

The unit pays the medical insurance for urban employees, and under normal circumstances, it is the grade that chooses to bring a personal account, and there is a fixed time every month to pay into it. This money can be used directly at designated pharmacies or hospitals. The overall reimbursement scope and reimbursement ratio should also exceed that of resident medical insurance.

2. The cost of medical insurance for urban residents is not the same, and it is also divided into multiple grades, but on the whole, it is not as good as the medical insurance for urban employees. Of course, as a self-employed person or freelancer, you can also choose to pay for your own employee medical insurance, but it costs more.

The reason is also very simple, when we work in the unit, the proportion of medical insurance payment is 2% by ourselves, and the unit pays 9% (there may be a difference in the proportion in different places). And as a freelancer, there will definitely be no one to cover the cost for us, and we will have to pay for the money ourselves. Because the benefits of employee medical insurance are relatively good, there are many freelancers who will choose to buy employee medical insurance.

3. Other gapsAs a person who has no job, whether it is urban residents' medical insurance or urban workers' medical insurance, whether you buy it or not depends on your personal will. The unit is different, according to the law, the five insurances must be paid for by law.

In addition, there is a difference in age, there is no age limit for resident medical insurance, and you can directly apply for insurance soon after birth. The state regulations do not allow the employment of child labor, so when buying insurance, there is naturally an age limit. Under normal circumstances, it should be over the age of 16 to be allowed to handle it.

To put it simply, it is to spend more money and protect more, spend less money to protect less, and you can choose both types of medical insurance, depending on your attitude.

The differences between individual payment and unit payment of medical insurance are: different payment conditions; The amount of payment is different, the individual medical insurance is borne by the individual, and the annual payment of the unit medical insurance is jointly borne by the unit and the individual, and the payment is made on a monthly basis; Reimbursement ratio, resident medical premium payment is lower, treatment is lower, reimbursement ratio is also low, unit payment cost is higher, treatment is higher, reimbursement ratio is also higher; Medical insurance treatment: Personal medical insurance is paid annually, and there is no retirement statement.

The difference is not particularly big, many times when buying medical insurance, the unit will bear a part, the individual needs to bear a part, and at the same time, when you see a doctor, you will also get the corresponding compensation, and the first way to buy is different.

The difference is that the money paid is different, if the individual pays, then he needs to pay all the part, and if the unit pays, then the unit will bear a part, and the individual needs to pay less.

Legal analysis: The difference between individual medical insurance and unit medical insurance mainly includes four aspects: 1. The payment conditions are different for different objects.

2. The amount of payment is orange: personal medical insurance is borne by the individual, on an annual basis; Unit medical insurance is borne by both units and individuals, and monthly payment 3, reimbursement ratio: resident medical premiums are lower, treatment is lower, and reimbursement ratio is also lower:

The unit cost is higher, the treatment is higher, and the reimbursement ratio is higher. 4. Medical insurance treatment: personal medical insurance is paid annually, there is no retirement statement, and some need to pay evenly; Employer medical insurance can retire.

Legal basis: Article 27 of the Social Security Law of the People's Republic of China If an individual who participates in the basic medical insurance for employees reaches the fixed retirement age and the cumulative fee reaches the number of years prescribed by the state, he or she will no longer pay the basic medical insurance fee after retirement, and shall enjoy the basic medical insurance treatment in accordance with the provisions of the state; Those who reach Huzhou at the end can pay the fee until the number of years specified by the state.

1. The medical insurance card is used for the reimbursement of medical insurance for the elderly and the elderly.

2. During the normal payment period of medical insurance, the insured can be reimbursed by using the medical insurance card for medical expenses in the hospital affiliated to the medical insurance in the insured area.

3. The insured will hand over the medical insurance card to the hospital charging window at the hospital** and pay the fee, and the current expenses can be reimbursed in real time. The expenses paid by the individual are the part of the expenses that need to be borne by the individual after being reimbursed by the medical insurance.

4. Note: The medical insurance card can only be used by oneself and cannot be lent to others. In addition, when paying for medical treatment, you must show your medical insurance card at the same time to enjoy real-time reimbursement of the current expenses.

Extended reading: How to return to Hanzi to buy, which is better, teach you to avoid these insurance"pits"

The difference between individual social security and company social security is that individuals pay social security in full by themselves, while companies pay part of their own social security and the company pays part of it. 1.The two definitions are different:

1) What we usually call the social security of employees in units generally includes: endowment insurance, medical insurance, work-related injury insurance, unemployment insurance and maternity insurance, referred to as five insurances. Among them, the payment obligations of endowment insurance, medical insurance and unemployment insurance shall be borne jointly by the employer and the employee, and the specific payment ratio shall be different in each province, while the payment obligation of work-related injury insurance and maternity insurance shall be borne by the employer.

2) Social security for flexibly employed persons (individuals) provides the most basic social security for flexibly employed persons, which mainly plays a role in promoting the rational flow of labor force and urbanization, and effectively protects the social security rights and interests of this special labor group. 2.The two types of insurance are different:

1) The social security of employees generally includes endowment insurance, medical insurance, work-related injury insurance, unemployment insurance and maternity insurance, referred to as five insurances. (2) Flexible employment personnel only participate in endowment insurance and medical insurance, and some areas can participate in unemployment insurance. The type of insurance is relatively simple.

The payment base of the two is different: (1) The payment base of the unit to pay social security is: the average salary of the employee in the previous year (300% of the high monthly social average, according to 300%; If it is less than 60% of the social level, it will be paid at 60%).

In other words, it is linked to the average salary of the employee himself. (2) The payment base of individual social security is fixed at high, medium and low levels, for individuals to choose, and the payment base of the three grades is between 60% and 300% of the social average, and the choice is flexible. 3.

The amount of payment is different between the two: (1) The social security pension, medical care and unemployment insurance paid by the unit shall be jointly borne by the unit and the individual Chongxin Burning person, with the unit accounting for the majority and the individual accounting for the small head. In addition, maternity insurance and work-related injury insurance are paid by the employer.

2) All the expenses of endowment insurance and medical insurance paid by individuals are borne by themselves, and the payment amount is relatively large. 4.There are household registration restrictions for both:

1) The social security paid by the unit is not divided into local or non-local, as long as it is full-time work, it can be paid. (2) Individuals who pay social security must be locals, and foreign people can only participate in employee social security, and there are certain geographical household registration restrictions. Article 58 of the Social Insurance Law of the People's Republic of China and Article 63 of the Social Insurance Law of the People's Republic of China.

Social Insurance Law of the People's Republic of China

Article 60. Employers shall declare and pay social insurance premiums in full and on time, and shall not defer or reduce or reduce social insurance premiums unless due to force majeure or other statutory reasons. The social insurance premiums to be paid by the employee shall be withheld and paid by the employer, and the employer shall inform the employee of the details of the social insurance premiums paid on a monthly basis.

Individually-owned businesses without employees, part-time employees who do not participate in social insurance at the employer, and other flexibly employed persons may directly pay social insurance premiums to the social insurance premium collection agency.