1, basic medical insurance for urban workers
The basic medical insurance for urban workers shall be paid by employers and individual workers in accordance with state regulations, and a medical insurance fund shall be established. After the insured person has medical expenses, the medical insurance agency should give certain economic compensation to avoid or reduce the economic risks caused by illness and treatment.
2. New rural cooperative medical system
The new rural cooperative medical system and the basic medical insurance for urban residents shall be combined with individual contributions and government subsidies, and the treatment standards shall be implemented in accordance with state regulations. In addition, the types of medical insurance in China also include commercial medical insurance, subsidized medical insurance, fee medical insurance and public medical care.
3. Basic medical insurance for urban residents
The basic medical insurance system for urban residents (referred to as residents' medical insurance) is aimed at students in primary and secondary schools (including vocational high schools and technical secondary schools) not covered by the basic medical insurance system for urban employees.
Extended data General medical insurance mainly includes general medical insurance, hospitalization medical insurance, surgery insurance and comprehensive medical insurance. Details are as follows:
1, general medical insurance
General medical insurance mainly provides general medical expenses for the insured to treat diseases, including outpatient expenses, examination expenses and medical expenses. This kind of insurance premium is relatively low and is more suitable for the general public.
2. Medical insurance
Generally, hospitalization expenses are relatively high, so most insurance companies will treat hospitalization expenses as a separate insurance. The expenses of hospitalization insurance mainly include doctors' treatment expenses, hospitalization expenses, operation expenses, medical equipment use fees, medical expenses, etc. Among them, the length of hospitalization will directly affect the cost. Therefore, the coverage of this insurance should be determined according to the average hospitalization expenses of patients.
3. Surgery insurance
Surgical insurance is the cost of providing patients who need necessary surgery. This kind of insurance usually covers all the expenses of the operation.
4. Comprehensive medical insurance
Comprehensive medical insurance is a comprehensive medical expense insurance provided by an insurance company for the insured. The initial expenses include all expenses such as hospitalization, diagnosis and treatment, and surgery. However, the premium of this kind of policy is relatively high, and generally a lower deductible and a suitable sharing ratio will be determined.
Legal basis: Regulations of People's Republic of China (PRC) Municipality on Basic Medical Insurance for Urban Workers.
Twenty-seventh employees of the employer who pay the basic medical insurance premiums in accordance with these regulations shall enjoy the basic medical insurance benefits.
Twenty-eighth personal accounts are used to pay medical expenses beyond the scope of the overall fund; If the personal account is insufficient to pay, it shall be borne by me.
Twenty-ninth serious illness hospitalization medical expenses, according to the following methods to pay:
(a) Qifubiaozhun in principle control in the city, county, autonomous county last year, the average social wage of workers 9%-0%.
(two) the maximum payment limit is controlled in principle at 3-5 times of the average social wage of employees in cities, counties and autonomous counties in the previous year.
(three) medical expenses above the minimum deductible and below the maximum payment limit are mainly paid by the overall fund, and individuals bear a certain proportion. Give appropriate care to the proportion of retirees who bear medical expenses.
The scope of serious diseases, the specific standards of Qifubiaozhun and the maximum payment limit, and the proportion of sharing medical expenses above Qifubiaozhun and below the maximum payment limit shall be determined by the provincial people's government.
Thirtieth medical expenses below Qifubiaozhun and above the maximum payment limit shall not be paid by the overall fund.
Thirty-first basic medical insurance fund to pay part of the cost of diagnosis and treatment projects and class B drugs list, the proportion of individual pays, determined by the provincial people's government.