1, medical insurance refers to social medical insurance. It is a social insurance system that meets the basic medical needs of the state and society according to laws and regulations when workers are sick. 20 16 65438+ 10/2 the State Council issued "opinions on integrating the basic medical insurance system for urban and rural residents" to promote the integration of medical insurance for urban residents and the new rural cooperative medical system, and gradually establish a unified national medical insurance system for urban and rural residents. On February 20th, 2065438+0616, Ministry of Human Resources and Social Security held a video conference on the nationwide networking of basic medical insurance and direct settlement of medical treatment in different places, and signed letters of responsibility with the first batch of 22 provinces including Beijing, which applied for nationwide networking of basic medical insurance and direct settlement of medical treatment in different places, marking the formal implementation stage of direct settlement of medical treatment in different places.
2. Characteristics of medical insurance: it has the characteristics of "low level and wide coverage", and the payment is based on the expenses that most units and individuals can afford at a low level, covering all units and employees in cities and towns, and employees of different units can enjoy the rights of basic medical insurance. The insured can enjoy it for life after completing the payment period. Secondly, the basic medical insurance has the characteristics of "the burden of both parties and the combination of unified accounts"; Based on the principle of "balance of payments".
3, medical insurance advantages: enjoy treatment according to unified standards. The same access conditions, the same fees, the same treatment, there is no difference between high and low. The employee's outpatient expenses can be deducted from his personal account and paid by the employee after deduction. The hospitalization expenses of employees shall be reimbursed in proportion: 1 1,000 yuan, and 86% of the expenses shall be reimbursed by tertiary hospitals; 65,438+0,000 to 20,000 yuan, and 88% of the expenses are reimbursed by tertiary hospitals; 20,000 to 40,000 yuan, and 92% of the expenses are reimbursed by tertiary hospitals. If employees have not been sick for several years in a row, personal account funds can be accumulated.
4. Defects in medical insurance: There is a basic deductible for each hospitalization, namely, the first-level hospital 500 yuan, the second-level hospital 750 yuan, and the third-level hospital 1 1,000 yuan, and these expenses need to be borne by employees themselves. Class A drugs and Class B drugs are reimbursed in proportion, and imported drugs are not reimbursed. If the amount exceeds 40 thousand, you have to pay for it yourself