How to choose a designated hospital to participate in medical insurance?

Methods of selecting designated hospitals for medical insurance

About medical insurance

Medical insurance is insurance to compensate medical expenses caused by diseases. Social insurance in which employees are provided with necessary medical services or material assistance by society or enterprises due to illness, injury or childbirth. The medical expenses of employees in China are shared by the state, units and individuals to reduce the burden on enterprises and avoid waste.

Minor ailments and injuries-nearby primary medical institutions

Many people show a vague face when choosing designated medical institutions. How should so many specialized hospitals and third hospitals choose? Generally speaking, you need to choose 1~2 small hospitals close to home. For minor illnesses such as colds, fever and stomachaches, you can directly find primary medical institutions close to home.

Primary medical institutions include: first-class hospitals designated by social security, outpatient departments, clinics, infirmary and community health service institutions.

Important medical security-comprehensive tertiary hospital

Choosing a comprehensive third-class first-class hospital in this district of the city will help you find medical security when you are sick. General hospitals can provide the most professional medical services because of their good medical conditions and many experts. However, the possible disadvantages of these hospitals are that it is difficult to register and there are many patients, so we must set a certain grade gradient when choosing to avoid overcrowding everywhere.

Medical insurance has a deductible, not 100% reimbursement.

According to the principle that the medical insurance fund and the insured individual share the medical expenses, if the medical expenses incurred by the insured in the designated medical institutions belong to the basic medical insurance coverage, they should bear a part first, and be paid by the medical insurance fund in accordance with the prescribed proportion.

Medical insurance has a deductible line and a cap line. The better the hospital, the higher the deductible. Registration fee, self-funded medicine and service fee will not be reimbursed.

For example, Beijing stipulates that when the medical expenses (including medicine expenses and examination fees) within the scope of medical insurance exceed the deductible line (on-the-job 1.800 yuan/year, retirement 1.300 yuan/year), social security depends on the level of the hospital (90% for the first-class in-service and 70% for the second-class or above; Retirement level 90%, above level 2 85%), the maximum reimbursement limit is 20 thousand yuan.

Designated medical hospitals can be changed after one year.

Under normal circumstances, designated medical institutions can be changed to professional social security institutions after one year.

Six insurances and one gold.

Nowadays, many enterprises with good welfare have increased the traditional five insurances and one gold to six insurances and one gold, and added commercial medical insurance for their employees. Many enterprise employees can enjoy basic social medical insurance reimbursement, and at the same time, they can also reimburse their own commercial insurance expenses.