What's the use of paying social security and medical insurance?

The functions of paying medical insurance include:

1. The reasonable and necessary medical expenses incurred by the insured due to illness or accident can be reimbursed, but the contents covered by different medical insurance are still different. For example, outpatient and emergency insurance mainly reimburses outpatient and emergency expenses; Accident medical insurance is mainly to reimburse accident medical expenses; Hospitalization insurance is mainly to reimburse hospitalization expenses; Millions of medical insurance mainly reimburses hospitalization medical expenses, outpatient surgery medical expenses, special outpatient medical expenses, and emergency medical expenses before and after hospitalization. Anti-cancer medical insurance is mainly to reimburse reasonable and necessary medical expenses caused by cancer;

2. It can be used as a supplement and basic guarantee to the basic medical insurance, but only the medical expenses in the medical insurance can be reimbursed, while commercial medical insurance can be used as a supplement to the basic medical insurance, such as reimbursement of self-funded medical expenses; Some commercial medical insurance can also reimburse expenses such as imported drugs.

Medical insurance refers to the basic medical insurance premium paid in full and on time by employers and employees according to the principle of compulsory social insurance through national legislation. If it is not paid in full and on time, the basic medical insurance fund for its medical expenses will not be paid, regardless of personal accounts. Take the proportion of medical insurance payment in Beijing as an example: the employer pays 65,438+00% of its total payment base every month, and the individual employee pays 2%+ 120 yuan as a serious illness co-ordination.

Medical insurance is insurance to compensate medical expenses caused by diseases. Social insurance in which employees are provided with necessary medical services or material assistance by society or enterprises due to illness, injury or childbirth. For example, free medical care and labor insurance medical care in China. The medical expenses of employees in China are shared by the state, units and individuals to reduce the burden on enterprises and avoid waste. Insurance liability accidents need to be handled, and the insurance money will be paid in proportion.

legal ground

People's Republic of China (PRC) social insurance law

Twenty-third, employees should participate in the basic medical insurance for employees, employers and employees should pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Twenty-seventh, individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.