Table 1 Comparison of UEBMI and URBMI policies in Guangzhou city in 2014

Inception year

2002

2008

Eligible population

Urban employed (employees; retirees)

Urban non-employed (children and full-time students; unemployed adults; elderly residents not covered by the UEBMI scheme)

Sources of funding

The employers contribute 6% of the employee’s salary whilst the employees contribute 2%

Retirees are exempt from premium contribution

Government subsidy (70%) and individual premium (30%)

CNY440 to CNY1800 per person per year for residents (including government subsidy)

Accounts

Medical savings account (including employee contributions and 30% of employer contributions) for outpatient care; social risk-pooling account (70% of employer contributions) for inpatient care and critical (i.e. chronic or fatal diseases including schizophrenia) outpatient care

Social risking-pooling account (all funds) for inpatient care and critical (i.e. chronic or fatal diseases including schizophrenia) outpatient care

Service package

Comprehensive

Limited

Inpatient

Inpatient

Benefit packages of social risk-pooling account

Employees

Primary hospitals

90%

Children and students

Primary hospitals

85%

Secondary hospitals

85%

Secondary hospitals

75%

Tertiary hospitals

80%

Tertiary hospitals

65%

Reimbursement rate (Inpatient care)

Retirees

Primary hospitals

93%

Unemployed adults and elderly residents

Primary hospitals

85%

Secondary hospitals

89.5%

Secondary hospitals

70%

Tertiary hospitals

86%

Tertiary hospitals

55%

Reimbursed ceiling (Inpatient care)

Six times of local employees’ annual average wage per year (CNY445,470)

Six times of local household disposable income per year (CNY228,324)

Critical outpatient

Critical outpatient

Reimbursement rate (Outpatient care)

Community health centers

85%

Community health centers

70%

Non-community institutes

65%

Non-community institutes

50%

Reimbursed ceiling (Outpatient care)

CNY150 per person per month

CNY100 per person per month