Before most foreigners find employment in Ningbo, they purchase various types of commercial medical insurance as one of the conditions for applying for work permits, and few participate in basic social medical insurance. On the one hand, it may be that employers want to save labor costs, and on the other hand, the insurance coverage that commercial medical insurance can provide within the unit cycle (usually 1 year) seems to be relatively high. However, from a practical point of view, social medical insurance may be more in line with the practicality of most people. The new policy shows that from December 1, 2024, the foreigner's work permit will be integrated with the social security card. Foreigners can receive an electronic social security card loaded with work permit information through the electronic social security card APP and enjoy the "one-card" service . This provides convenient conditions for foreigners to purchase medical insurance, although there is currently no mandatory requirement for foreigners to purchase basic social medical insurance when applying for a work permit. However, it is worth noting that both foreigners and local Chinese enjoy equal rights and interests in basic social medical insurance.

多数外国人在宁波就业前，大多通过购买各类商业医疗保险作为申请工作许可的条件之一，少有参加社会基本医疗保险。一方面可能是用人单位为了节省人力支出成本，另一方面，单位周期内（通常是1年）商业医疗保险可提供的保险保额，看起来比较高。但是从实践角度来说，社会医保可能更加贴合大多数人的实用性。新政显示，自2024年12月1日起，外国人工作许可证与社会保障卡（社保卡）融合集成，外国人可以通过电子社保卡APP领取加载工作许可信息的电子社保卡，享受“一卡通”服务。这给外国人购买医疗保险提供了便利的条件，虽然目前没有强制要求外国人在申请工作证时，需要同时购买社会基本医疗保险。但是，值得说明的是，社会基本医疗保险无论外国人还是本地中国人，都享有同等的权益。

There are two types of outpatient benefits under Ningbo's employee basic medical insurance: general outpatient benefits and outpatient special disease benefits . So, what are the specific benefits?

宁波市的职工基本医疗保险的门诊待遇分为两种，分别是普通门诊待遇和门诊特病待遇。那么，具体有哪些权益呢？

1

general outpatient care

普通门诊

Let’s talk about general outpatient care first: Let’s first understand three terms: account segment, self-payment segment, and co-payment segment; as well as three accounts: current year account (individual insured person), historical year account (individual insured person), and pooling fund account (all insured persons)

首先说说普通门诊：我们先了解三个词：账户段、自付段、共付段；以及三个账户：当年账户（参保人个人）、历年账户（参保人个人）、统筹基金账户（所有参保人）

• Account segment: During the medical insurance year, medical expenses are first paid from the individual's account for that year. (The unpaid balance in the individual account will be carried forward to the historical year’s account)
• Self-payment segment: After the current year account funds are used up, you need to pay a certain amount of money (900 yuan for those under 45 years old, 600 yuan for those over 45 years old, and 300 yuan for retirees). (You can use your historical year’s account)
• Co-payment segment: After the Self-payment segment, the medical insurance pooling fund and the individual share the cost in proportion. Depending on the hospital and age group, the individual payment ranges from 8% to 25%, and the pooling fund payment ranges from 75% to 92%.
• 账户段：医保年度内，医疗费用先由个人当年账户支付。（个人账户当年未支付完的会结转如历年账户）
• 自付段：个人账户资金用完后，需自付一定金额（45岁以下900元，45岁以上600元，退休人员300元）。（可以用本人的历年账户）
• 共付段：超出自负段后，医保统筹基金和个人按比例分担费用。根据医院和年龄段的不同，个人支付从8%-25%不等，统筹基金支付：从75%-92%不等。

2

Treatment of special diseases in outpatient clinics

门诊特病待遇

• There are 9 specific items for outpatient special disease treatment, mainly including: treatment of malignant tumors; dialysis treatment of severe uremia; organ and tissue transplantation ; 10 special mental diseases such as bipolar disorder; treatment of systemic lupus erythematosus; treatment of aplastic anemia; treatment of hemophilia; treatment of tuberculosis and epilepsy. We will not elaborate on this here.
• When the insured persons of the city's employee medical insurance receive outpatient treatment for special disease treatment projects, they will pay 8% of the fee themselves and the pooling fund will pay 92% . For insured persons who have completed the registration procedures for special disease medical insurance, there is no deductible for hospitalization, and the settlement is based on hospitalization benefits. Registration procedures should be completed in advance for outpatient treatment of special diseases .
• 门诊特殊病种治疗具体项目有9类，主要包括：恶性肿瘤治疗；重症尿毒症透析治疗；器官器官、组织移植术；双相情感障碍等10项精神类特殊病种；系统性红斑狼疮治疗；再生障碍性贫血治疗；血友病治疗；肺结核等治疗；癫痫治疗。这里不作详述。
• 我市职工医保参保人员进行特殊病种治疗项目门诊治疗时，个人自付8％，统筹基金支付92%。已办理特殊病种医保备案手续的参保人员，住院治疗时不设置起付线，按住院待遇结算。门诊特殊病种治疗应事先办理备案手续。

Therefore, based on the above description of rights and interests, from a long-term perspective, if you have the conditions, you should try to consider employee medical insurance; and even if you leave China one day, the money in the medical insurance account can still be withdrawn.

所以，通过以上的权益描述，从长远考虑，有条件的你还是应该尽量考虑职工医疗保险；而且即使当你哪天离开中国的时候，医保账户里的钱还可以提取哦。

If you have any questions about the above article, please feel free to contact our service consultant for a more detailed answer.

如果你对以上文章有疑问的，欢迎联系我们的服务顾问为你做更加细微地解答。

Author 作者 | Ryan