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 unit 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, 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.
Legal basis: People's Republic of China (PRC) Social Insurance Law.
Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.