Types of medical insurance

Medical insurance is mainly divided into four categories:

First, medical insurance for urban workers.

Second, flexible employment is called medical insurance.

Third, medical insurance for urban residents, which is aimed at urban hukou residents, has a lower reimbursement rate than urban employees, and no one has a medical insurance account, that is, there is no money in the social security card, which can only be used for reimbursement, and it can only be used for hospitalization reimbursement, not for outpatient reimbursement.

Fourth, the new rural cooperative medical system, also known as the new rural cooperative medical system, can only be used for hospitalization reimbursement.

Social security is the general name of several social insurances, including medical insurance, endowment insurance, maternity insurance, unemployment insurance and industrial injury insurance. Urban workers will basically pay three to five types of insurance, and urban residents will pay one to three types of insurance. Among them, the most important social insurance is medical and endowment insurance.

Simply put, medical insurance is to establish a medical insurance fund through the contributions of employers and individuals. After the insured person has medical expenses, the medical insurance institution will give certain economic compensation, but medical insurance is different.

Commercial medical insurance units or individuals voluntarily participate, and the government has no mandatory regulations. Units or individuals pay all insurance premiums, and the government does not subsidize them. For example: critical illness insurance, full insurance for high incidence and major diseases, compensatory insurance for hospitalization, accident medical insurance and so on.

What is the difference between medical insurance for urban workers and medical insurance for urban residents?

1, applicable to different people.

2. Different payment methods.

3. Enjoy different treatment

4, medical management requirements are different.

Advantages of medical insurance:

Enjoy treatment according to uniform standards. The same access conditions, the same fees, the same treatment, there is no difference between high and low. The employee's outpatient expenses can be deducted from his personal account and paid by the employee after deduction. The hospitalization expenses of employees shall be reimbursed in proportion: 1 1,000 yuan, and 86% of the expenses shall be reimbursed by tertiary hospitals; 65,438+0,000 to 20,000 yuan, and 88% of the expenses are reimbursed by tertiary hospitals; 20,000 to 40,000 yuan, and 92% of the expenses are reimbursed by tertiary hospitals. If employees have not been sick for several years in a row, personal account funds can be accumulated.

Legal basis:

People's Republic of China (PRC) Civil Code

Twenty-seventh individuals who participate in the basic medical insurance for employees, when they reach the statutory retirement age, will no longer pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with state regulations; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.