Table 1 Comparison of UEBMI and URBMI policies in Shaanxi Province in 2008
UEBMI | URBMI | |
|---|---|---|
Year of launch | 1999 | 2007 |
Enrolment unit/type | Individual/Mandatory | Individual/Voluntary |
Sources of revenues | The employer contribute 6% of the employee’ salary whilst the employee contribute 2%; the retired are exempt from premium contribution | 200 to 350RMB per person per year for residents (including government contributions) |
Accounts | Medical Savings Account (including employee contributions and 30% of employer contributions) for outpatient utilisation; Social Pooling Account (70% of employer contributions) for inpatient utilisation and critical (i.e. chronic or fatal disease) outpatient utilisation | Social Pooling Account (all funds) for inpatient utilisation and critical (i.e. chronic or fatal disease) outpatient utilisation |
Benefit package† of Social Pooling Account | INPATIENT & CRITICAL OUTPATIENT | CRITICAL OUTPATIENT |
• Deductible: | • Deductible: | |
6%-10% of local employees’ annual average wage | 0-350 RMB | |
• Reimbursement rate: | ||
• Reimbursement rate: | 50%-70% | |
80%-95% | • Ceiling: | |
• Ceiling: | 2,000-40,000 RMB | |
4 times of local employees’ annual average wage | INPATIENT | |
• Deductible: | ||
550-800, 400–600, 300–400 and 150–300 RMB for tertiary, secondary, primary, and community medical institutes, respectively | ||
• Reimbursement rate: | ||
40%-75% for adults; 45%-85% for students and residents under 18 and not attending school | ||
• Ceiling: | ||
24,000-35,000 RMB for adults; 30,000-60,000 for students and residents under 18 and not attending school | ||
Payment method | Fee-for-service | Fee-for-service |