After comprehensive evaluation, the disability level is above level 4, and those who receive nursing services enjoy long-term insurance benefits. Long-term care insurance refers to the insurance that pays the expenses incurred by individuals who cannot take care of themselves due to old age, illness or disability and need to be accompanied by a special person at home or a nursing home. Long-term care insurance belongs to the category of health insurance, and the subject matter is personal health. Usually the nursing period is long, which may be half a year, one year, several years or even more than ten years. The significance of nursing is to maintain a guarantee as long as possible, mainly to pay the daily nursing expenses of the elderly, or the daily nursing expenses caused by illness or disability. Generally divided into home care and institutional care. The difference between medical insurance and medical insurance is that medical insurance mainly guarantees the expenses needed for medical treatment, while long-term care insurance is mainly used to guarantee the expenses paid for general life care, generally excluding medical intervention.
Social insurance refers to a social and economic system that provides income or compensation for people who lose their ability to work, are temporarily unemployed or suffer losses due to health reasons. The main items of social insurance include endowment insurance, medical insurance, unemployment insurance, industrial injury insurance and maternity insurance.
The social insurance plan is organized by the government, forcing a certain group to use part of its income as social insurance tax (fee) to form a social insurance fund. Under certain conditions, the insured can get fixed income or loss compensation from the fund. It is a redistribution system, and its goal is to ensure the reproduction of material and labor and social stability.
In China, social insurance is an important part of the social security system, occupying a core position in the whole social security system. In addition, social insurance is a contributory social security. The funds are mainly paid by employers and workers themselves, and the government finances give subsidies and bear the ultimate responsibility. However, workers can only enjoy the corresponding social insurance benefits if they fulfill their statutory payment obligations and meet the statutory conditions.
Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities and emergency and rescue medical expenses standards, and shall be paid from the basic medical insurance fund in accordance with state regulations.
Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.