Basic knowledge of social security and commercial insurance

Today, let's learn about social security and commercial insurance.

First, the existing security system.

Generally speaking, the current security system in China can be divided into two categories.

The first category is social pooling insurance.

Mainly include

Endowment: social endowment insurance

Medical care: employee medical insurance, resident medical insurance, new rural cooperative medical system;

As well as unemployment insurance, maternity insurance and industrial injury insurance.

Among them, social endowment insurance, employee medical insurance, unemployment insurance, maternity insurance and industrial injury insurance are commonly known as "five insurances", and people working in the unit are assigned to employees by the unit.

Residents' medical insurance and the new rural cooperative medical system, now also called urban and rural residents' medical insurance, need to pay their own fees for people who don't have a job, such as children, self-employed people and freelancers.

The second category is commercial insurance.

There are many kinds of commercial insurance. In short, it can be divided into two categories.

The first category, life insurance.

Life insurance can be divided into personal protection of health protection and asset preservation of cash protection.

1, personal safety class

Here is mainly to provide corresponding protection for three things that will happen in life: big things, small things and nothing.

Major events refer to death, major illness and disability.

Commercial insurance can show the value of life for the insured and make up for the loss of income to the family.

When major events occur, economic losses are often infinite and unpredictable.

Small things refer to medical expenses caused by diseases or accidents.

For example, medical expenses caused by an illness, or medical expenses caused by accidents.

The trivial matters mentioned here refer more to the estimated hospitalization expenses.

Nothing refers to things that will happen without risk, such as education and old-age care.

People may not get sick, but they will get old. When they are old and need to provide for the elderly, it will cost money. The quality of life they need is different, and the cost of providing for the elderly is also different.

The same goes for children's education. According to the expected level of education in the future, the required education expenses are also different.

Whether it is pension or education fund, it is a measurable cash flow, which needs to be prepared in advance. Pension needs to be as long as life.

2. Asset protection category

Here mainly refers to the cash flow management of families or enterprises, such as asset stripping, asset preservation, asset inheritance and so on.

The purpose is that hard-won financial resources will not fall behind others because of some unpredictable risks.

This will not be expanded for the time being. If so, you need to write more articles.

The second category is property insurance.

The most common thing here is our car insurance.

Of course, there are home insurance, corporate liability insurance and so on.

Second, the reimbursement ratio of social medical insurance.

I say this alone because many people have great misunderstandings about this matter at present.

At present, commonly known as "social security" often refers to social medical insurance, including employee medical insurance, urban residents medical insurance and new rural cooperative medical care. (The latter two are now called medical care for urban and rural residents)

Either way, there is social medical insurance.

In the case of the three, the reimbursement ratio will be a little different.

Employees' medical insurance reimbursement rate is the highest, which can reach about 90% in social security;

The proportion of medical insurance for urban residents is the second, which can reach about 70-80% of social security;

The reimbursement rate of the new rural cooperative medical system is the lowest, which is about 60-70% of social security.

However, in either case, the reimbursement ratio refers to social security.

At present, drugs are mainly divided into three categories.

Class A drugs: 1858, which are fully reimbursed by medical insurance and are also the most common generic drugs;

Class B drugs: 8 17 kinds, some of which need to be paid at their own expense, accounting for about10%-30%;

Class C drugs: 1.9 million kinds, domestic 1.8 million kinds, imported 9000 kinds, all at their own expense, the effect is very good.

Social medical insurance mainly reimburses Class A drugs and some Class B drugs.

This is why we see that many people have medical insurance and need to raise it easily. It was because of a serious illness that I found that social security was completely inadequate. This is a claim case actually handled by Ozawa's team. As you can see, this statement clearly states the class A drugs, class B drugs, self-funded drugs and so on.

Then this is a video that is very popular on the Internet these days.

The patient was finally cured by surgery, but the final cost was as follows:

Total hospitalization expenses 10000 yuan, medical insurance expenses 10000 yuan, and self-payment 10000 yuan.

This is also the limitation of medical insurance.

However, Ozawa stressed that social medical insurance is the welfare of the state for every resident and can provide basic protection for everyone, so it must be available.

But we should know that social medical insurance alone is not enough. Our common sense is that the reimbursement rate is limited to social security, so in most cases, the actual reimbursement rate is much lower than the reimbursement rate, and the greater the disease, the higher the proportion of self-funded drugs and imported drugs other than social security, and the lower the social security reimbursement rate.

Three. Overview of life insurance

As mentioned above, life is mainly three things.

And commercial insurance, generally speaking, is three types.

Payment can transfer the economic losses caused by major events in life;

Reimbursement can transfer medical expenses caused by small things in life;

Compulsory savings is to plan in advance the education expenses or pensions that people will face when they are idle.

Life insurance can have corresponding solutions to all kinds of problems that life will face.

Students: provide education expenses and children's lifelong cash flow reserve;

Old: provide pension expenses and provide us with cash flow as long as life;

Sickness: provide medical expenses and rehabilitation expenses to make up for the income loss caused by illness;

Death: you can inherit assets reasonably, leaving love and debt.

Life insurance is to provide corresponding value when life reaches a certain point in time or triggers an event.