I. Coverage of medical insurance
The medical insurance management system covers a wide range, including basic medical insurance for urban workers and basic medical insurance for urban and rural residents. These insurance systems are designed to ensure the basic medical needs of all kinds of people and ensure that citizens can get timely and effective medical treatment when facing the risk of disease.
Second, the financing mechanism of medical insurance
The financing of medical insurance is mainly realized by individual contributions, unit contributions and government subsidies. Individuals and units pay medical insurance premiums according to a certain proportion to form a medical insurance fund. The government supports the medical insurance fund through financial subsidies and other means to ensure the stable operation of the fund.
Three. Payment of medical insurance benefits
When the insured suffers medical expenses due to illness or accidental injury, he may apply to the medical insurance institution for treatment and payment. Medical insurance institutions will compensate according to a certain proportion and standard according to the actual situation of the insured and the rationality of medical expenses. This will help to reduce the financial burden of the insured and ensure their basic livelihood.
Four, the management and supervision of medical insurance
In order to ensure the normal operation of the medical insurance system and the safe use of funds, the government has set up a special medical insurance management institution to manage and supervise the financing and payment of medical insurance. At the same time, establish and improve the supervision mechanism, strengthen the supervision and assessment of medical insurance institutions, and ensure their compliance operation.
To sum up:
Medical insurance management system is a social security system implemented by the state and society to solve the economic burden of citizens in terms of disease risk. By raising medical insurance funds, the medical expenses of the insured are compensated and their basic medical needs are guaranteed. In order to ensure the normal operation of the medical insurance system and the safe use of funds, the government has set up a special management organization to manage and supervise.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 23 provides that:
Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
Article 25 provides that:
The state establishes and improves the basic medical insurance system for urban residents.
The basic medical insurance for urban residents combines individual contributions with government subsidies.
People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.