What kind of insurance does medical insurance include?

Medical insurance includes the following details:

1. Comprehensive medical insurance: it provides comprehensive protection and will provide reimbursement for hospitalization, outpatient service, surgery and other expenses for the insured;

2. Specific medical insurance: it is the guarantee to provide consumers with specific medical items;

3. General medical insurance: it is the general expenses for the insured to treat diseases;

4. Hospitalization medical insurance: hospitalization for illness requires relatively high expenses, while the reimbursement amount of basic medical insurance is limited;

5. Surgical medical insurance.

Basic medical insurance is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the contributions of employers and individuals. After the insured person has medical expenses, the medical insurance agency will give certain economic compensation to avoid or reduce the economic risks caused by illness and treatment.

legal ground

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

Twenty-third employees should participate in the basic medical insurance for employees, and the employer and employees should jointly pay the basic medical insurance premiums in accordance with state regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations. 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.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits. Thirtieth the following medical expenses are not included in the basic medical insurance fund payment scope:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(3) borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.