Compared with basic medical insurance, supplementary medical insurance includes enterprise supplementary medical insurance, commercial medical insurance, social mutual assistance and community medical insurance, which is a powerful supplement to basic medical insurance and an important part of multi-level medical security system. Different from basic medical insurance, supplementary medical insurance is not enforced by national legislation, but is voluntarily participated by employers and individuals. It is a kind of supplementary insurance that units or individuals increase medical insurance items appropriately according to the needs and possible principles after the units and employees participate in the unified basic medical insurance to improve the level of insurance protection. Basic medical insurance and supplementary medical insurance are not contradictory, but complementary and irreplaceable, and their purpose is to provide medical security for employees.

1. Enterprises that participate in various social insurances according to regulations and pay social insurance premiums in full and on time can decide whether to establish supplementary medical insurance;

2. Supplementary medical insurance fund, which is used for enterprises to participate in local basic medical insurance according to regulations, and to provide appropriate subsidies for medical expenses borne by employees in addition to the treatment paid by the basic medical insurance system for urban employees, so as to reduce the medical expenses burden of insured employees;

3. The part of the supplementary medical insurance premium of the enterprise within 5% of the total wages can be directly charged from the cost, and it is no longer subject to the examination and approval of the financial department at the same level;

4. The supplementary medical insurance measures of enterprises should be connected with the local basic medical insurance system;

Supplementary medical reimbursement will not be reimbursed under the following circumstances:

1. All medical expenses of outpatient and hospitalization in medical institutions that are not designated by me, and medical expenses that do not meet or exceed the scope and standard of reimbursement for basic medical insurance;

2. Drug expenses that are inconsistent with the diagnosis, self-funded drugs, and purchased drugs beyond the basic medical insurance requirements;

3. All medical expenses caused by suicide, self-mutilation, drug abuse, fighting, fighting, alcoholism, traffic accidents and medical accidents;

4. All medical expenses incurred overseas and all medical expenses for medical treatment and hospitalization in special needs clinics;

5. All medical expenses for pre-pregnancy check-up, all medical expenses for diagnosis and treatment of infertility, all medical expenses for preventive medication and medical expenses that should be paid by individuals according to national and municipal regulations.

I hope the above contents can help you. If you have any other questions, please consult a professional lawyer.

Legal basis: Article 28 of the Social Insurance Law

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.

article 29

the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, medical institutions and pharmaceutical trading units.

the social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in different places, so as to facilitate the insured to enjoy the basic medical insurance benefits.