Medical Insurance 101 (2)
Payment of allowance
In short, paid medical insurance is medical insurance that the insurance company pays the insurance premium to the insured person on a time, day or item basis according to the subsidy standard stipulated in the contract . The claims have nothing to do with the actual medical costs incurred and there is no need to provide invoices.
Medical insurance insurers recommend that the purchase of medical insurance first consider the issue of reimbursement of medical expenses and, second, the problem of compensation for losses due to hospitalization cannot be considered. It is only by consolidating the basic protection and supplementing on this basis that the icing on the cake. For those with sufficient social protection, medical insurance can give priority to subsidized medical insurance.
Principles of insurance In insurance, the question arises as to "whether the principle of compensation applies to health insurance". This question cannot be generalized. The principle of compensation refers to "the compensation obtained by the insured cannot be greater than his actual loss". Paid medical insurance is not applicable and the payment of insurance money has nothing to do with the actual loss. The design principle is in fact to consider the loss of wages caused by sick leave during the hospitalization of the insured, so that the contract stipulates that the subsidy costs must be paid according to the number of days of hospitalization. It does not take into account the cost of actual hospitalization and has nothing to do with the actual economic loss. ".
Fresh
The medical insurance costs are based on the actual medical costs incurred by the client to pay the insurance premiums according to the amount of insurance agreed on the policy. The goal is to compensate for the client's medical expenses. The client must issue an outpatient or hospitalization invoice when making a claim, and the scope of the claim is basically the same as that of "Social Security".
In addition, there are strict restrictions on social medical insurance. New drugs, imported drugs and expensive drugs are not covered by reimbursement of medical social insurance. Social medical insurance is not reimbursed for medical costs caused by traffic accidents. In addition, expenses that often arise during illness, such as nutrition, nursing and lost time, are not included in the reimbursement.
Therefore, people with medical insurance can purchase medical insurance for inpatients and consider purchasing additional expense-based and grant-type supplements. Choosing expense-based medical insurance is also a useful addition.
effect
1. It is conducive to improving labor productivity and promoting the development of production.
Medical insurance is the inevitable result of social progress and the development of production. In turn, the establishment and improvement of the medical insurance system will further promote social progress and the development of production. On the one hand, medical insurance relieves the worries of workers and allows them to work with peace of mind, thus improving work productivity and promoting the development of production; on the other hand, it also guarantees the physical and mental health of workers and the normal reproduction of work.
2. Resolve income differences and reflect social equity.
Medical insurance is an important means of government redistribution through the collection of medical insurance premiums and payment of medical insurance services to regulate income gaps.
3. An important guarantee for the maintenance of social stability.
Medical insurance provides financial assistance to sick workers, helps to eliminate social instability caused by disease, and is an important social mechanism for adjusting social relationships and social contradictions.
4. An important means of promoting social civilization and progress.
The social system of medical insurance and mutual social assistance, by sharing the risk of illness among the insured, reflects the new social relationship of "one party in difficulty and the support of eight parties", favorable the promotion of social civilization and progress.
5. An important guarantee for advancing the reform of the economic system, in particular the reform of public enterprises.
