What is the relationship between social medical insurance and commercial insurance

First, the attributes of the two are different.

1. Commercial medical insurance is a type of insurance operated by life insurance companies by means of economic compensation, which is an aspect of social and economic activities, which is realized by signing a contract between the insurer and the policyholder in accordance with the principle of voluntariness, and the life insurance company can make a profit from it;

2. Social medical insurance is a social security system established by the state in accordance with the provisions of the Constitution to protect and improve the health of employees, which is enforced by the state or local government through legislation, does not depend on personal will, and is non-profit in nature as a social welfare undertaking.

Second, the object and role of insurance are different.

1. Commercial medical insurance takes natural persons as the insurance object, and its function is that when the insured citizens pay medical expenses due to accidental injury or illness, they can obtain certain economic compensation to reduce losses;

2. Social medical insurance mainly takes workers as the insurance object, and when workers pay medical expenses due to illness, the social insurance department or its entrusted unit will give basic compensation, which is conducive to social stability and maintaining social fairness, and is actually an aspect of national income redistribution.

3. The reciprocity of rights and obligations between the two is different.

1. The rights and obligations of commercial medical insurance are based on the contractual relationship, any citizen or legal person with full capacity for conduct, as long as the insurance company voluntarily signs an insurance contract and pays the insurance premium according to the provisions of the contract, he or a member can obtain the right to claim the corresponding insurance payment, the amount of insurance depends on the amount of insurance premiums paid, that is, the rights and obligations between the insurance company and the policyholder is a kind of equivalent exchange of reciprocal relationship, which is manifested as more insurance, less insurance, no insurance;

2. The relationship between the rights and obligations of social medical insurance is established on the labor relationship, as long as the worker fulfills the obligation to work for the society, he can enjoy the social medical insurance treatment, sometimes in order to facilitate the management of economic means and enhance the cost awareness of the laborer, he is required to pay a small amount of insurance premiums, but the insurance benefits they receive are not proportional to the amount of insurance premiums paid, that is, the relationship between rights and obligations is not equal.

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Commercial medical insurance is a supplement to social medical insurance, citizens should participate in social medical insurance in accordance with the law, on the basis of participating in social medical insurance, according to the individual's economic ability, choose to participate in commercial medical insurance, to ensure that individuals in the event of a major illness, can effectively reduce the burden of personal medical expenses.

The difference between social medical insurance and commercial medical insurance includes the following three aspects:

1. Mandatory different.

Social medical insurance is mandatory, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state.

Article 23 of the Social Insurance Law of the People's Republic of China stipulates that employees shall participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state.

Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

Commercial medical insurance is not mandatory, commercial medical insurance is an integral part of the medical security system, and units and individuals voluntarily participate.

Second, the object and role of insurance are different.

Commercial medical insurance takes natural persons as the insurance object, and its function is that when the insured citizens pay medical expenses due to accidental injury or illness, they can obtain certain economic compensation to reduce the loss, rather than to protect the basic life of the insured, and it does not have the role of maintaining social fairness;

Social medical insurance mainly takes workers as the insurance object, and when workers pay medical expenses due to illness, the social insurance department or its entrusted unit will give basic compensation, which is conducive to social stability and maintaining social fairness, and is actually an aspect of national income redistribution.

3. The reciprocity of rights and obligations between the two is different.

The rights and obligations of commercial medical insurance are based on the contractual relationship, and the amount of insurance depends on the amount of insurance premiums paid, that is, the rights and obligations between the insurance company and the policyholder are a kind of equivalent exchange of reciprocal relationship, which is manifested as more insurance, less insurance, and no insurance.

The relationship between the rights and obligations of social medical insurance is based on the labor relationship, as long as the worker fulfills the obligation to work for the society, he can enjoy the treatment of social medical insurance, and the insurance payment is not proportional to the amount of insurance premiums paid, that is, the relationship between rights and obligations is not equal.

Encyclopedia - Commercial Medical Insurance"Encyclopedia - Commercial Medical Insurance

Encyclopedia - Social Insurance Law of the People's Republic of China"Encyclopedia - Social Insurance Law of the People's Republic of China

Arnold answers: Hello!

1. The attributes of the two are different. Commercial medical insurance is a type of insurance operated by insurance companies by means of economic compensation, which is realized by signing a contract between the insurer and the policyholder in accordance with the principle of voluntariness. The social medical insurance is a social security system established by the state in accordance with the provisions of the Constitution to protect the health of employees, which is enforced by the state or local government through legislation, and does not depend on the will of the individual.

2. The object and function of insurance are different. Commercial medical insurance takes natural persons as the object of insurance. Social medical insurance mainly takes workers as the insurance object, and when workers pay medical expenses due to illness, the social insurance department or its entrusted unit will give basic compensation.

3. The reciprocity of rights and obligations between the two is different. The amount of commercial insurance depends on the amount of insurance premiums paid, that is, the relationship of rights and obligations between the insurance company and the policyholder is a reciprocal relationship of equivalent exchange. As long as the worker pays a small amount of insurance premiums, he can get a higher level of protection, that is, the insurance benefits received by the workers are not proportional to the amount of insurance premiums they pay, that is, the relationship between rights and obligations is not equal.

The continuous improvement of social medical insurance provides more and more comprehensive protection for people, and the number of people enjoying medical insurance protection is gradually increasing. Commercial medical insurance is an important supplement to social security and provides people with better protection. So what is the difference between social medical insurance and commercial medical insurance?

First of all, the properties of the two are different. Commercial medical insurance is a type of insurance operated by life insurance companies by means of economic compensation, which is an aspect of social and economic activities, which is realized by the contract signed by both the insurer and the policyholder in accordance with the principle of voluntariness, and the life insurance company can make a profit from it. Social medical insurance is a social security system established by the state in accordance with the provisions of the Constitution to protect and improve the health of employees, which is enforced by the state or local through legislation, does not depend on the will of the individual, and is non-profit in nature as a social welfare undertaking.

Secondly, the object and role of insurance are different. Commercial medical insurance to natural persons as the object of insurance, its role is that when the insured citizens due to accidental injury or illness and medical expenses, can obtain a certain amount of economic compensation to reduce losses, not in order to protect the basic life of the insured, nor does it have the role of maintaining social fairness, social medical insurance mainly to workers as the insurance object, when the worker due to illness and medical expenses and medical expenses, by the social insurance department or its entrusted unit to give basic compensation, is conducive to social stability and maintenance of social fairness, In fact, it is an aspect of the redistribution of national income.

Thirdly, the reciprocity of rights and obligations between the two is different. The rights and obligations of commercial medical insurance are based on the contractual relationship, any citizen or legal person with full capacity for conduct, as long as the insurance company voluntarily signs an insurance contract and pays the insurance premium according to the provisions of the contract, he or a member can obtain the corresponding right to claim the payment of insurance money, the amount of insurance depends on the amount of insurance premiums paid, that is, the rights and obligations between the insurance company and the policyholder is a reciprocal relationship of equivalent exchange, which is manifested as more insurance, less insurance, no insurance. The relationship between the rights and obligations of social medical insurance is established on the labor relationship, as long as the worker fulfills the obligation to work for the society, he can enjoy the social medical insurance treatment, sometimes in order to facilitate the management of economic means, enhance the cost awareness of the worker, and require a small amount of insurance premiums, but the insurance benefits they receive are not proportional to the amount of insurance premiums paid, that is, the relationship between rights and obligations is not equal.

Bao Ge Tips: To sum up, it can be seen that there is a big difference between commercial medical insurance and social medical insurance, but both can provide people with different degrees of protection. Social insurance is a "guarantee but not an all-inclusive", while commercial medical insurance is an important supplement to social security, providing more comprehensive protection.

Relationship: Social medical insurance is a security system established by the state to enable citizens to receive compensation and help in the event of loss of ability to work in old age, illness, unemployment, work-related injury, childbirth, etc. It is compulsory to insure, and the premium is reasonably borne by individuals, enterprises, and **.

Its purpose is to ensure the basic livelihood of workers and maintain social stability. The main form of commercial health insurance is that the insurance company assumes the responsibility to pay the insurance money when the insured dies, is disabled, sick or reaches the agreed age and period according to the contract. It is voluntarily insured by the policyholder, and the individual pays the insurance premium to the insurance company.

Social medical insurance has the advantages of wide coverage, no restrictions on the insured population, relatively low premiums, and low compensation thresholds. But there are also some shortcomings. First of all, the level of social medical insurance protection is low.

The standard of social medical insurance payment is based on the premise of ensuring the basic life of the insured, which is far from enough for the policyholder who pursues a high-quality life. Secondly, the social medical insurance has a single type and function, and is based on the principle of social fairness, which cannot meet the different requirements of all social strata. Commercial health insurance provides customers with more choices by designing different rates and different products.

All in all, social medical insurance focuses on protection, and commercial health insurance focuses on compensation, and the two go their own ways and complement each other.

Differences: Manifested in seven aspects.

1. The scope of services provided is different.

2. The implementation methods are different.

3. The calculation method of insurance rate is different.

4. Different payment methods.

5. The business purpose is different.

6. Insurance premiums** are different.

7. The principle of insurance payment is different.

1. The difference between work-related injury insurance and accident insurance.

It is understood that the differences between accident insurance and work-related injury insurance are mainly in the following aspects:

1. The nature of insurance is different: accident insurance is a commercial insurance, and the relationship between the insurer and the insured is completely voluntary; Work-related injury insurance is a social insurance and is mandatory, and the employer must insure the employee in accordance with the regulations, otherwise it will have to bear certain legal liabilities.

2. The existing legal relationship is different: the legal basis of accident insurance is the general civil contract relationship; The legal basis of work-related injury insurance is the realization of the administrative functions of the state.

3. The purpose of implementation is different: accident insurance is a business behavior that obtains profits by complying with people's requirements for risk avoidance; Work-related injury insurance, on the other hand, is not for profit, but for the purpose of ensuring the basic livelihood of workers, maintaining social stability, and promoting economic development.

4. Different ways of paying premiums: the premiums of accident insurance are borne by the policyholders, and when the income and expenditure of the insurance company are unbalanced, the state finance will not give any subsidies; The premium of work-related injury insurance is borne by the employer, and the employee does not need to pay it. When the income and expenditure of the enterprise are not balanced, the state finance will subsidize it.

5. The scope of protection is different: the protection of accident insurance is not divided into time, place and cause of injury, and is mainly for the reimbursement of medical expenses caused by accidental injury of the insured. At the same time, if the insured person becomes disabled due to accidental injury, the disability allowance can also be compensated proportionately; Work-related injury insurance only reimburses medical expenses incurred as a result of an accidental injury suffered as a result of work.

Insurance is now an indispensable basic guarantee for everyone in family life, and now there are many types of insurance, social medical insurance and commercial medical insurance are the most common, although they are medical insurance, but there is a difference between the two.

First of all, these two are different conditions, when the employee medical insurance and urban and rural residents participate in the medical insurance, there is no condition for the insured, the insured can enjoy the medical insurance treatment as long as they pay the premium, and the commercial medical insurance requires the insured to perform the health notification system, if there is a past medical history, the premium will be increased, and some people may not be able to participate in the insurance.

The second is the difference in the cost of insurance. <>

Medical insurance for urban and rural residents is paid annually, and the fee in 2022 is 320 yuan. Employee medical insurance is compulsory to be paid by a fixed work unit, and the cost is borne by the unit and the individual.

Commercial medical insurance is voluntary, the insured can decide whether to pay according to their own income, the cost of commercial medical insurance is related to the type of insurance and the age of the insured, generally the older the insured charges, the younger the charge will be lower.

The nature of these two types of insurance is different, urban and rural residents' medical insurance and urban workers' medical insurance are social insurance, which is a kind of welfare treatment in our country, without restriction on age and medical history, and the scope of protection is relatively wide. <>

Commercial medical insurance is launched by insurance companies, for the purpose of profit, voluntary purchase as the choice, and the insured also chooses whether to buy according to their own situation.

How to buy these two kinds of insurance, I personally think that social medical insurance must be bought, about 70% reimbursement for employees, about 50% reimbursement for urban and rural residents, if there are conditions, you can buy a commercial insurance alone, the part that social insurance can not reimburse, commercial insurance can be reimbursed. Business insurance can be chosen by yourself. <>