Does medical insurance have critical illness insurance?

Medical insurance does not include medical insurance for serious illness. Critical illness insurance is a separate insurance, which is not covered by medical insurance. However, the coverage of serious illness insurance should be connected with urban residents' medical insurance and the new rural cooperative medical system.

The medical insurance for urban residents and the new rural cooperative medical system should provide basic medical security according to the policy. On this basis, the major illness insurance mainly guarantees the eligible medical expenses of urban residents compensated by medical insurance and the new rural cooperative medical system when the insured (co-insured) is seriously ill and the medical expenses are high.

High medical expenses can be judged by the fact that the accumulated annual compliance medical expenses of individuals exceed the annual per capita disposable income of urban residents and the annual per capita net income of rural residents announced by local statistical departments, and the specific amount is determined by local governments.

Compliance medical expenses refer to the actual and reasonable medical expenses (which can be stipulated not to be paid), which are determined by the local government. All localities can also start to carry out serious illness insurance from diseases with heavy personal burden.

The diseases covered by medical insurance for serious illness include: childhood leukemia, end-stage renal disease, breast cancer, cervical cancer, severe mental illness, drug-resistant tuberculosis, opportunistic infection of AIDS, hemophilia, chronic myeloid leukemia, cleft lip and palate, lung cancer, esophageal cancer, gastric cancer, type I diabetes, hyperthyroidism, acute myocardial infarction, cerebral infarction, colon cancer and rectal cancer.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to receive material assistance from the state and society in accordance with the law in case of old age, illness, industrial injury, unemployment and maternity.

Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Social insurance law

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Social insurance law

Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.