The difference between reimbursement within social security and reimbursement outside social security

The difference between reimbursement within social security scope and reimbursement outside social security scope is as follows:

1. Reimbursement scope: Reimbursement within social security refers to medical expenses within the scope of social security, including outpatient service, hospitalization, examination, laboratory tests, surgery and other expenses. Reimbursement outside social security refers to medical expenses not covered by social security, including some high-end medical expenses, beauty, physical examination, etc.

2. Reimbursement ratio: The social security fund is responsible for paying the medical expenses reimbursed in social security, and the reimbursement ratio varies according to different medical expenses and regional policies. Reimbursement outside social security is generally borne by individuals themselves, and the proportion of reimbursement is low or not.

Social security includes the following contents:

1, old-age insurance, which guarantees the future old-age life. The insured can receive the pension on time after retirement, and can receive funeral expenses and pensions when he dies early;

2. Medical insurance, because medical expenses can be reimbursed according to regulations; After the payment reaches a certain number of years, retirement can also enjoy medical insurance benefits;

3, unemployment insurance, unemployment insurance can provide an unemployment insurance premium and subsidies when the insured does not take the initiative to unemployment;

4. Work injury insurance. If the insured is injured during work, the insured can pay the treatment fee, life care fee and disability allowance through work-related injury insurance, and provide disability allowance;

5. Maternity insurance, which provides reimbursement and subsidies for the check-up and medical expenses during childbirth.

To sum up, if you need to use social security to reimburse medical expenses, it is recommended to know the specific policies and operation methods from the local social security department. If you need reimbursement other than social security, you can learn about relevant insurance products and services from commercial medical insurance companies.

Legal basis:

Article 8 of the Implementation of Several Provisions

The medical expenses incurred by the insured in the agreed medical institutions that meet the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards shall be paid from the basic medical insurance fund in accordance with state regulations.

If the insured really needs emergency treatment and rescue, he can seek medical treatment in a non-agreement medical institution; The scope of drugs that must be used for rescue can be appropriately relaxed. The specific measures for the administration of emergency and rescue medical services of the insured shall be formulated by the overall planning area according to the local actual situation.