Medical insurance refers to social medical insurance. Social medical insurance is a social insurance system established by the state and society according to certain laws and regulations to provide basic medical needs for workers within the scope of protection. The basic medical insurance fund consists of overall funds and individual accounts. The basic medical insurance premiums paid by individual employees are all included in individual accounts; The basic medical insurance premium paid by the employer is divided into two parts, one part is included in the personal account, and the other part is used to establish the overall fund.
Medical insurance has the characteristics of "low level and wide coverage". The payment is based on the expenses that most units and individuals can bear at a low level, covering all units and employees in cities and towns, and employees in different units can enjoy the rights of basic medical insurance. The insured can enjoy it for life after completing the payment period. Secondly, the basic medical insurance has the characteristics of "the burden of both parties and the combination of unified accounts"; Based on the principle of "balance of payments".
legal ground
Some Provisions on Implementing the Social Insurance Law of People's Republic of China (PRC)
Article 8 The medical expenses incurred by the insured in the agreed medical institutions shall be paid by the basic medical insurance fund in accordance with the provisions of the state if they meet the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards.
If the insured really needs emergency treatment and rescue, he can seek medical treatment in a non-agreement medical institution; The scope of drugs that must be used for rescue can be appropriately relaxed. The specific measures for the administration of emergency and rescue medical services of the insured shall be formulated by the overall planning area according to the local actual situation.