Medical insurance for urban and rural residents 1. General outpatient reimbursement: Urban and rural residents can be reimbursed up to 300 yuan per year (up to 30 yuan each time) for outpatient visits at township health centers or community health service centers; 2. Special outpatient diseases: hypertension, diabetes, etc.
29 types of diseases are included in special outpatient diseases; 3. Hospitalization reimbursement: Hospitalization expenses in the medical insurance catalog are reimbursed at the rates of 90%, 75%, and 45% for first-, second-, and third-level hospitals respectively. Hospitals outside the city are registered.
Afterwards, the social security card will be directly reimbursed at 35% (if not registered, the reimbursement rate will be 30%); 4. Critical illness insurance benefits: After the basic medical insurance is reimbursed, if the total personal burden in the remaining medical insurance catalog exceeds 15,000 yuan, it will be reimbursed under the critical illness insurance segment.
Medical insurance with an annual maximum payment limit of 200,000 yuan per person refers to the fact that through national legislation, basic medical insurance premiums should be paid in full and on time by employers and individual employees in accordance with the principle of compulsory social insurance.
If payment is not made in full and on time, the basic medical insurance pooling fund will not pay for medical expenses, regardless of personal account.
Take the medical insurance payment ratio in Beijing as an example: the employer pays 10% of its total payment base every month, and the employee pays 2% of his salary + 3 yuan for serious illness.
Medical insurance is a type of insurance that compensates for medical expenses caused by illness.
Social insurance that provides necessary medical services or material assistance to employees due to illness, injury, or childbirth, provided by the society or the enterprise.
Such as China's publicly funded medical care and labor insurance medical care.
The medical expenses of Chinese employees are jointly borne by the state, units and individuals to reduce the burden on enterprises and avoid waste.
If an insured accident requires treatment, the insurance premium will be paid in proportion.
Origin Development Medical insurance originated in Western Europe and can be traced back to the Middle Ages.
With the success of the bourgeois revolution, family workshops were replaced by large industries, and a modern industrial team emerged.
Due to the harsh working environment and the occurrence of epidemic diseases and work-related injuries, workers require corresponding medical care.
However, their wages are low and it is difficult for individuals to pay for medical expenses.
As a result, workers in many places organized spontaneously to raise part of the funds for expenses when they were sick.
However, this form is not very stable, is small-scale, and has low ability to withstand risks.
At the end of the 18th century and the beginning of the 19th century, private insurance developed in Western Europe and became an important way for the country to raise medical funds.
Medical insurance has the basic characteristics of social insurance such as compulsory, mutual aid, and social nature.
Therefore, the medical insurance system is usually legislated and enforced by the state, and a fund system is established. The fees are paid jointly by the employer and the individual, and the medical insurance premiums are paid by the medical insurance institution to solve the problems caused by workers' illness or injury.
medical risks.
Classification can be divided into social medical insurance and commercial medical insurance according to their nature.