Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the contributions of employers and individuals. After the insured person has medical expenses, the medical insurance institution will give certain economic compensation.
The establishment and implementation of the basic medical insurance system has gathered the economic strength of units and social members. With the government's funding, sick social members can get necessary material help from the society, reduce the burden of medical expenses, and prevent sick social members from "poverty due to illness".
Medical insurance has the basic characteristics of social insurance, such as compulsion, mutual assistance and sociality. The medical insurance system is usually legislated and enforced by the state, and a fund system is established. The expenses are paid jointly by the employer and the individual, and the medical insurance premium is paid by the medical insurance institution to solve the medical risks caused by the illness or injury of the employees.
Medical insurance, like other types of insurance, collects medical insurance premiums from people threatened by diseases in advance in the form of contracts and establishes medical insurance funds; When the insured goes to a medical institution for medical treatment, the medical insurance institution will give him some economic compensation. Therefore, medical insurance also has two functions of insurance: risk transfer and compensation transfer. That is, the economic losses caused by individual disease risks are distributed to all members threatened by the same risks, and the economic losses caused by diseases are compensated by centralized medical insurance funds.
Commercial medical insurance can be divided into reimbursement medical insurance and compensation medical insurance.
Reimbursement medical insurance means that the medical expenses spent by patients in hospitals are reimbursed by insurance companies, which are generally divided into outpatient medical insurance and inpatient medical insurance.
Compensatory medical insurance refers to the fact that the patient is definitely diagnosed by the hospital with a certain disease listed in the contract, and the insurance company pays the patient's treatment and nursing expenses according to the amount agreed in the contract. Generally divided into single disease insurance and critical illness insurance.
legal ground
People's Republic of China (PRC) social insurance law
Twenty-third 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.
skill
The above answer is only for the current information combined with my understanding of the law, please refer carefully!
If you still have questions about this issue, I suggest you sort out relevant information and communicate with professionals in detail.