Proportion of teachers' medical insurance payment

Generally speaking, public teachers belong to the official career establishment of the state, and belong to fully funded educational units, so they do not need to pay endowment insurance, so they only have four insurances and one gold; Teachers in private schools are contracted and need to pay five insurances and one gold.

The five insurances and one gold paid by teachers include endowment insurance, medical insurance, unemployment insurance, work injury insurance, maternity insurance and housing accumulation fund. Among them, individuals participate in paying insurance, such as pension, medical care, unemployment insurance and other social security projects, as well as provident fund.

As for how to calculate the teacher's five insurances and one gold, this is also divided into public and private teachers. Generally, the standard for private teachers to pay five insurances and one gold is the same as that of local enterprise employees. You can consult the social security bureau or the housing provident fund management center.

Endowment insurance: 20% for employers and 8% for employees.

Medical insurance: 6% for employers and 2% for employees.

Medical insurance reimbursement is similar to that of local employees.

1. The personal account of teachers' medical insurance will reimburse the following medical expenses:

Outpatient and emergency medical expenses; The cost of purchasing drugs at designated retail pharmacies; Medical expenses below the Qifubiaozhun of the basic medical insurance pooling fund; Medical expenses that exceed the qifubiaozhun of the basic medical insurance pooling fund and should be borne by individuals in proportion.

2, the teacher medical insurance fund to reimburse the following medical expenses:

Hospitalization medical expenses; Emergency rescue observation and income hospitalization, medical expenses within 7 days before hospitalization observation; Outpatient medical expenses of taking anti-rejection drugs after radiotherapy and chemotherapy, renal dialysis and renal transplantation for malignant tumors.

The contribution ratio of medical insurance for enterprise employees is: 8% of the unit contribution base and 2% of the individual contribution base of employees.

However, it should be reminded that the base of employee medical insurance payment in different provinces and cities is different. Moreover, the scope of social security medical reimbursement is limited to projects within the scope of social security.

The scope of social security refers to our medical insurance catalogue, including medical insurance drugs catalogue, diagnosis and treatment items catalogue and medical service facilities. The medical expenses are within the scope of the medical insurance catalogue, and medical insurance can be reimbursed. Beyond the scope of the catalogue, you can only pay for it yourself.

Therefore, teachers' medical security is still one of the most basic social security and will be limited by medical security resources (public hospitals, general departments, etc.). ), the scope of protection (drugs and items within the scope of social security) and the amount of protection (the highest annual reimbursement amount and proportion, deductible line, etc.). ). If you want to solve the problem of better protection of self-funded drugs and hospital resources, you need to configure corresponding commercial security projects for yourself.

Legal basis:

"People's Republic of China (PRC) social insurance law" thirtieth the following medical expenses are not included in the scope of payment of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.