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.
Medical insurance is an insurance product that provides protection for medical expenses. Its main functions are as follows:
1. Reduce the financial burden: When medical treatment is needed due to illness or accident, medical insurance can help pay part or all of the medical expenses, thus reducing the financial burden.
2. Improve the accessibility of treatment: Medical insurance can provide patients with more treatment options, including public hospitals, private hospitals and clinics, and can get better medical services.
3. Prevention of overtreatment: Medical insurance can prevent overtreatment and unnecessary examination by setting annual budget and expense limit, thus reducing medical expenses.
4. Encourage preventive medical care: Medical insurance can encourage people to pay more attention to their health, have regular physical examinations and take other preventive measures, thus reducing the risk of illness.
5. Guarantee the financial stability of the family: If it is the economic pillar of the family, medical insurance can help you continue to work when you are sick and avoid debt and family financial crisis caused by medical expenses.
6. Abide by public health policies: Medical insurance companies usually make insurance plans according to government guidance and policies, which makes medical insurance an effective tool to abide by public health policies.
To sum up, the main function of medical insurance is to help individuals and families cope with the economic pressure caused by diseases and accidents, improve the accessibility and quality of medical services, and maintain the stability of family finances by providing medical expenses.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 87
Social insurance agencies, medical institutions, pharmaceutical trading units and other social insurance service institutions defraud social insurance fund expenditures by fraud, forgery of certification materials or other means, and the social insurance administrative department shall order them to return the defrauded social insurance money and impose a fine of more than 2 times and less than 5 times the amount defrauded; If it belongs to a social insurance service institution, the service agreement shall be terminated; If the directly responsible person in charge and other directly responsible personnel are qualified, their qualifications shall be revoked according to law.