Is public medical care medical insurance?

Free medical care refers to a social security system implemented by the state to protect national staff and provide free medical care and preventive services to those who enjoy it through medical and health departments in accordance with regulations.

The difference between medical care at public expense and medical insurance is mainly different in concept, coverage, scope of protection, burden subject and reimbursement ratio. For example, ordinary people are not eligible for public medical care at all. All public medical care is essentially aimed at national civil servants, and the reimbursement rate of public medical care is higher than that of ordinary medical insurance.

The reimbursement process of hospitalization medical insurance and matters needing attention

1. When entering or leaving the hospital, you must go through the registration formalities with the medical insurance IC card at the medical insurance management window of each designated medical institution. When in hospital, the individual pays the deposit of medical expenses in advance, and pays more and less after discharge. Medical expenses incurred before hospitalization registration are not included in the payment scope of basic medical insurance. If the emergency hospitalization fails to go through the hospitalization registration formalities in time, the emergency certificate should be used to go through the hospitalization formalities at the medical insurance management window the day after admission (postponed in case of holidays), and the overdue medical expenses should be borne by themselves.

2. The deductible line of the overall fund after the insured person is hospitalized: the deductible line varies from place to place, which is generally 10% of the average annual salary of employees in the whole city in the previous year. In a basic medical insurance settlement year, the medical expenses for multiple hospitalizations are calculated cumulatively.

3. If the insured person needs to be referred or transferred due to illness, the deputy chief physician or chief physician of the designated medical institution at or above the third level shall put forward the opinions of referral (hospital) after diagnosis, and the unit to which he belongs shall fill in the application form and go through the referral (hospital) formalities with the approval of the medical insurance management department of the designated medical institution.

The transfer is limited to provincial specialized hospitals, and the expenses are paid by me first. The reimbursement standard is 10% first, and then the reimbursable amount is calculated according to local regulations.

4. When the designated medical institutions are discharged from the hospital, the designated medical institutions will calculate the reimbursement amount of medical insurance and the amount that individuals should pay. The reimbursement amount will be settled by the designated medical institutions and urban social insurance agencies, and the amount that individuals should pay will be settled by the designated medical institutions and the insured.

I hope the above content can help you. Please consult a professional lawyer if you have any other questions.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Fifth people's governments at or above the county level shall incorporate social insurance into the national economic and social development plan.

The state raises social insurance funds through multiple channels. People's governments at or above the county level shall give necessary financial support to social insurance.

The state supports social insurance through preferential tax policies.

Seventieth social insurance agencies shall regularly announce to the public the participation in social insurance and the income and expenditure, balance and income of social insurance funds.

Seventy-second social insurance agencies should be established in the overall planning area. According to the needs of the work, with the approval of the local social insurance administrative department and the organization management organ, the social insurance agency may set up branches and service outlets in this overall planning area.

The personnel expenses of social insurance agencies and the basic operating expenses and management expenses incurred in handling social insurance shall be guaranteed by the finance at the same level in accordance with state regulations.

pass the exam