It is suggested that the reimbursement of medical expenses should be considered first when purchasing medical insurance, and then the compensation for losses caused by hospitalization can be considered. Only by consolidating the basic security and supplementing it on this basis can we add icing on the cake. People with adequate social insurance can give priority to subsidizing medical insurance when choosing medical insurance.
Reimbursement medical insurance means that the medical expenses spent by patients in hospitals are reimbursed by insurance companies, which are generally divided into outpatient medical insurance and inpatient medical insurance.
Compensatory medical insurance refers to the fact that the patient is definitely diagnosed by the hospital with a certain disease listed in the contract, and the insurance company pays the patient's treatment and nursing expenses according to the amount agreed in the contract. Generally divided into single disease insurance and critical illness insurance.
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 ground
People's Republic of China (PRC) social insurance law
Article 87 Where social insurance agencies, medical institutions, pharmaceutical trading entities and other social insurance service institutions defraud social insurance fund expenditures by means of fraud or forgery of certification materials, the social insurance administrative department shall order them to return the defrauded social insurance money and impose a fine of more than 2 times but less than 5 times the amount defrauded; If it belongs to a social insurance service institution, the service agreement shall be terminated; If the directly responsible person in charge and other directly responsible personnel are qualified, their qualifications shall be revoked according to law.