The difference between designated and non-designated medical insurance

Legal analysis: 1. The reimbursement amount is different.

The amount of reimbursement in designated hospitals will be relatively more. When you go to a designated hospital, you can enjoy a certain proportion of reimbursement: in a "small point", the proportion of reimbursement for medicine expenses can reach 80%; In the "big point" hospital, those who go through the "small point" before referral will be reimbursed 55%, and those who go directly to the "big point" without referral will be reimbursed 45%.

2. Different checkout methods

When you are hospitalized in a designated hospital, you can directly offset the expenses when you check out, as long as the offset amount is paid. If it is not a fixed point, you must apply for hospitalization first, otherwise you may not be reimbursed. The hospitalization expenses are paid in advance, and then reimbursed by social security. Generally speaking, designated hospitals have regulations and cannot apply for changes.

3. Different medical institutions

Designated medical institutions refer to medical institutions that provide medical services for the insured through equal communication, consultation and agreement with medical insurance agencies. Including public medical institutions and private medical institutions with certain qualifications. The medical expenses incurred by the insured in designated medical institutions can be reimbursed according to the relevant policies and regulations of medical insurance, and the medical expenses incurred in non-medical insurance designated medical institutions (except emergency) are not reimbursed according to the provisions of medical insurance policies.

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

Article 4 Employers and individuals in People's Republic of China (PRC) shall pay social insurance premiums according to law, and have the right to inquire about payment records and personal rights and interests records, and ask social insurance agencies to provide social insurance consultation and other related services.

Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.

Article 58 An employing unit shall, within 30 days from the date of employment, apply to the social insurance agency for social insurance registration for its employees. If the social insurance has not been registered, the social insurance agency shall verify the social insurance premium it should pay.

Employees-free individual industrial and commercial households who voluntarily participate in social insurance, part-time employees who do not participate in social insurance in the employing unit and other flexible employees shall apply to the social insurance agency for social insurance registration.

The state establishes a national unified personal social security number. Personal social security number is a citizen's identity number.

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The above answer is only for the current information combined with my understanding of the law, please refer carefully!

If you still have questions about this issue, I suggest you sort out relevant information and communicate with professionals in detail.