After social medical insurance reimbursement, how to reimburse commercial insurance?

Social security and commercial insurance reimbursement:

Sub-reimbursement: go to social security reimbursement first, and then report the rest to commercial insurance companies.

1. Social insurance is compulsory insurance required by the state. The state develops social insurance undertakings, establishes a social insurance system and sets up a social insurance fund, with the aim of enabling workers to get help and enjoy insurance benefits in old age, illness, work injury, unemployment and childbirth. China's "Labor Law" and "Social Insurance Law" clearly stipulate that it is the legal obligation of the employer to pay social insurance for workers, which is obviously compulsory by the state, and the employer shall not refuse to undertake this legal obligation under any excuse or reason.

Second, commercial insurance is generally a kind of commercial insurance for insurance companies, which has a certain commercial nature and is a supplement to social security.

Generally speaking, after paying supplementary medical insurance, patients only need to bear 5%-30% of the expenses after hospitalization. Due to local policies, supplementary medical insurance is different, and there is still an upper limit.

The insurance liability for general hospitalization is: if the insured needs hospitalization due to non-major diseases, resulting in medical expenses, the payment amount is equal to 80% of the actual medical expenses, and the accumulated compensation in each insurance period can reach the general hospitalization insurance amount specified in the insurance policy. Since the scope of social basic medical insurance and commercial basic medical insurance is the same, the self-funded part should be paid by itself.

Medical expenses caused by traffic accidents, as well as social medical insurance such as treatment expenses, rehabilitation expenses and nursing expenses during hospitalization will not be reimbursed. It can be seen that social security is only the most basic guarantee for on-the-job employees, which is limited to the average level of society. In order to further obtain medical insurance, it must be supplemented by commercial insurance.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.