What diseases does social security medical insurance cover?

The difficulty of seeing a doctor has become a social concern, and the most important problem is the funds needed for seeing a doctor. Many families can't afford a serious illness, so the demand for serious illness insurance is very urgent. However, many people still don't know much about critical illness insurance, and some even think that they think that critical illness is within the scope of critical illness insurance. This is actually a misunderstanding.

The medical coverage of social security for serious illness includes the coverage of social security for serious illness and the reimbursement of social security for serious illness. The object of serious illness insurance is urban residents' medical insurance and the insured of the new rural cooperative medical system, and the required funds are extracted from the urban residents' medical insurance fund and the new rural cooperative medical system fund, without increasing the burden of individual contributions.

What diseases does critical illness medical insurance cover?

In some cities, the critical illness insured by medical insurance for critical illness is not defined by the disease type, but by the personal expenses of residents. For example, in Beijing, only the expenses that meet the reimbursement scope of basic medical insurance for urban and rural residents in Beijing and the high expenses after reimbursement of basic medical insurance are included in the payment scope of major illness insurance for urban and rural residents in Beijing for secondary reimbursement. Whether by disease or by cost, it all points to one point, that is, it is in line with the scope of reimbursement for residents' basic medical insurance.

The new rural cooperative medical system covers 20 major diseases such as childhood leukemia, congenital heart disease, severe mental illness, breast cancer, cervical cancer, end-stage renal disease, multidrug-resistant tuberculosis, AIDS opportunistic infection, lung cancer, esophageal cancer, gastric cancer, colon cancer, rectal cancer, chronic myeloid leukemia, acute myocardial infarction, cerebral infarction, hemophilia, type I diabetes, hyperthyroidism and cleft lip and palate.

Coverage not covered by medical insurance for major diseases

The coverage of critical illness medical insurance is as follows: 1. See a doctor in a non-designated hospital without approval (except for emergency rescue); 2. Suffering from occupational diseases, work-related injuries or recurrence of old injuries; 3. Injuries caused by traffic accidents; 4. Injuries caused by my illegal acts; 5. Food poisoning caused by accidents; 6. receiving treatment for suicide; 7. Injuries caused by medical accidents; 8. According to the regulations of the state and this Municipality, medical expenses should be taken care of.

Every insured person who participates in the basic medical insurance pays the medical insurance premium for serious illness to the municipal and district social insurance bureaus every year in 48 yuan. Medical expenses exceeding the maximum payment limit of the basic medical pooling fund shall be reimbursed by the social security department for 85% below RMB 0-40,000, 90% below RMB 40,000-80,000 and 95% above RMB 80,000. The maximum payment limit for each medical year is 6.5438 yuan +0.5 million yuan.

The above is the coverage and exclusion liability of critical illness insurance. I hope everyone can know fairly well.