Is serious illness medical care social security?

Serious illness medical treatment is a part of social security and an important part of China's social security system.

First, the concept and scope of serious illness medical treatment

As the name implies, the medical care for critical illness refers to the medical security provided by the pointer for major diseases. In our country, medical treatment for serious diseases usually includes malignant tumor, acute myocardial infarction, stroke sequelae and other serious diseases. These diseases are often expensive to treat, which brings heavy economic burden to patients and families. Therefore, the establishment of critical illness medical care aims to reduce the economic pressure of patients and families and help them better cope with the challenges of diseases.

Second, the relationship between serious illness medical care and social security

As a part of social security, serious illness medical care is closely linked with social security. The social security system covers pension, medical care, work injury, unemployment, maternity and other aspects, providing all-round social security for citizens. Among them, medical insurance is an important part of social security, and serious illness medical treatment is an extension and supplement of medical insurance. By participating in social security, individuals and units jointly pay medical insurance premiums to form a medical insurance fund, which is used to pay the medical expenses of the insured, including serious illness medical expenses.

Third, the guarantee function of serious illness medical treatment.

The guarantee function of serious illness medical treatment is mainly reflected in the following aspects: first, serious illness medical treatment can reduce the economic burden of patients and families and help them cope with high treatment costs; Secondly, serious illness medical treatment can improve the medical quality of patients and enable them to choose better medical institutions and more advanced treatment technologies; Finally, serious illness medical treatment can reduce the risk of poverty caused by illness and maintain social stability and fairness.

Four, serious illness medical application and reimbursement process

Generally speaking, after the insured person is diagnosed with a serious illness, he needs to submit application materials to the social security department in accordance with relevant regulations, including diagnosis certificate and medical expense invoice. After the examination and approval, the social security department pays the patients or medical institutions the medical expenses for serious illness that meet the requirements from the medical insurance fund. The specific application and reimbursement process may be different due to regional and policy differences, and the insured should pay attention to the relevant information released by the local social security department.

To sum up:

As an important part of social security, serious illness medical care provides important economic security for the insured to face major diseases. Individuals and units contribute to the construction of a sound social security system by participating in social security and paying medical insurance fees. The guarantee function of serious illness medical care is not only reflected in reducing the economic burden and improving the quality of medical care, but also helps to maintain social stability and fairness. Therefore, we should actively understand and participate in medical insurance for critical illness to protect the health of ourselves and our families.

Legal basis:

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

Article 23 provides that:

Employees should participate in the basic medical insurance for employees, and 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.

Article 25 provides that:

The state establishes and improves the basic medical insurance system for urban residents.

The basic medical insurance for urban residents combines individual contributions with government subsidies.

People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.

Article 26 provides that:

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Article 27 provides that:

Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; 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.

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

Article 28 provides that:

Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Article 29 provides that:

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.