The difference between supplementary medical insurance and basic medical insurance

Supplementary medical care is relative to basic medical care, depending on the voluntary nature of the employer and the individual. Employers and employees who have already purchased basic medical care should appropriately increase the medical insurance items according to the needs of the units or individuals.

Basic medical insurance is a rough house, which can only protect our most basic medical needs, and supplementary medical insurance is finely decorated, which can meet our diverse medical needs. The specific differences can be seen below.

Corporate supplementary medical care, commercial medical care, social mutual aid and community medical care are all supplementary medical care, which is worthy of being a powerful supplement to basic medical care. Like social security and commercial insurance, they are also complementary to each other, I won't say much here, if you want to know more, you can click here:Is there a difference between social security and commercial insurance?

Do I not have to buy commercial insurance if I buy social security? 》

1.Supplementary medical care is paid once a year, and it can be paid this year or not next yearYou can only be reimbursed if you have paid it, and if you don't pay it, you won't be reimbursed.

2.In normal medical treatment, the purchase of drugs and supplementary medical treatment can be reimbursedMedical reimbursement must be at least three days of hospitalization before it can be reimbursed.

3.Complementary medical care has a certain scope of reimbursementChildbirth, plastic surgery, etc. are not allowed to be reimbursed, and generally the company is responsible for half of it and pays half by itself.

4.If you have already paid for supplementary medical care,Remember to keep your medical records, lists, and invoices when you see a doctor. If you want to reimburse the invoice, you have to take the relevant medical records and lists to stamp, and the three are indispensable.

5.After that, bring your medical records, lists, and invoices to the Human Resources Department for reimbursementRelevant ** need to fill in and provide a bank card number, and you will generally receive reimbursement in about a month.

In order to give you a more comprehensive grasp, I have also sorted out the issues related to medical insurance reimbursement for easy reference:What are the circumstances under which medical insurance does not reimburse? 》Hope!

Let me give you an example, and you will understand: There are 3 types of medical insurance in Shenzhen: comprehensive medical care, inpatient medical care, and labor medical care, including basic medical care and local supplementary medical care, and labor medical care only basic medical care.

The differences between them are mainly in terms of treatment: (1) Basic medical care and local supplementary medical care have their own drug catalogue and diagnosis and treatment catalogue respectively.

Assuming that drug A is available in the local supplementary drug list and is not in the basic medical drug list, then the insured who buys comprehensive and hospitalization can be reimbursed, but those who buy labor medical care are not reimbursed.

The same is true for diagnosis and treatment items: (2) The amount of reimbursement is different.

There will be a separate coordinator for local complementary medical care**. For example, if you buy 8 months of medical insurance, the amount of reimbursement for the sick Zhuyuan for the insured who buys comprehensive and hospitalization is more than 96,000, while the insured who buys labor medical care is only more than 40,000.

3) PET is an examination item specializing in malignant tumor examination, and it costs more than 10,000 phone bills to do it once, and this is only reimbursed by the insured who has bought local supplementary medical care, that is, those who buy comprehensive and hospitalization have some reports, and those who buy labor workers do not report In general, local complementary and basic medical care are two different co-ordination**, with their own drug catalogue and diagnosis and treatment catalogue. Some drugs are reimbursable in local supplements, but not in the list of essential medical medicines.

There is a clear difference between supplementary medical insurance and basic medical insurance in social security. Basic medical insurance is available to everyone who pays social security contributions, while supplementary medical insurance indicates that the basic medical insurance amount is used up and needs to be supplemented before it can continue to be used.

Answer: 1. Different requirements: basic medical insurance is an insurance in social security, and basic medical insurance requires payment to be sustainable. If the payment is interrupted in the middle of the payment, it will not be available for the next month.

Wait until the payment is resumed, and you can continue to use it after three months. The basic medical insurance is stipulated by the state, and the unit must help the employees pay the insurance, which is mandatory to a certain extent.

2. Different proportions: supplementary medical insurance is an insurance voluntarily participated in by employers and individuals, and is not mandatory by the state. Reimbursement ratio of supplementary medical insuranceSupplementary medical insurance is the part that cannot be reimbursed by supplementary basic medical care, and supplementary medical insurance is reimbursed again.

For example, there is an upper limit on the reimbursement of social security, so the excess department needs to bear it personally, and if there is supplementary medical insurance, you can reimburse the excess part, so that the part of your own reimbursement becomes less, reducing the pressure on the individual to bear the part.

This ratio is generally determined by the choice of the unit. Generally, supplementary medical insurance can be reimbursed by 60%-90% after social security reimbursement, and the specific proportion is chosen by the unit.

3. The reimbursement amount is different: the cost of supplementary medical insurance is determined according to the reimbursement ratio, the higher the reimbursement ratio, the more expensive the premium, and if the reimbursement ratio is low, the cost is lower.

The difference between supplementary medical insurance and basic medical insuranceThe difference between supplementary medical insurance and basic medical insurance The difference between supplementary medical insurance and basic medical insurance includes the following three aspects: 1. Mandatory differences.

Supplementary medical insurance is not enforced through national legislation, but is voluntarily participated in by employers and individuals. It is a kind of supplementary insurance that improves the level of insurance protection by units or individuals according to the needs and possible principles after participating in the unified basic medical insurance. Basic medical insurance is mandatory.

In December 1998, the Decision on the Establishment of the Basic Medical Insurance System for Urban Employees (Guo Fa [1998] No. 44) was promulgated, requiring the establishment of a multi-level medical security system with the basic medical insurance system for urban employees as the core nationwide. Second, the types are different. Supplementary medical insurance includes various forms such as enterprise supplementary medical insurance, commercial medical insurance, social mutual aid and community medical insurance, which is a powerful supplement to basic medical insurance and an important part of the multi-level medical security system.

Basic medical insurance is a social insurance established to compensate workers for economic losses caused by the risk of disease, through the employer and individual contributions, the establishment of medical insurance**, the insured personnel after the medical expenses incurred in the medical treatment, by the medical insurance agency to give certain economic compensation. 3. The payment base is different. The part of the supplementary medical insurance premium of the enterprise within 5% of the total salary can be directly paid from the cost, and it will no longer be approved by the financial department at the same level.

The supplementary medical insurance measures for enterprises should be connected with the local basic medical insurance system. The payment base of basic medical insurance is that the employer takes the total salary of the employee stipulated by the state as the payment base, and the employee takes the salary income of the previous year as the payment base. If the wage income of employees is higher than 300% of the average salary of local employees, 300% of the average salary of local employees shall be used as the payment base.

Do you understand this explanation?

<> The main differences between medical insurance and social security are as follows:

1. The concept is different.

The social security card is the social security card, which is an integrated circuit card issued by the local human resources and social security departments for the society and used in various business fields of human resources and social security.

The medical insurance card is a special card for medical insurance personal accounts, which uses the personal ID card as the identification code to store and record the personal ID number, name, gender, and detailed information such as the allocation and consumption of account funds.

2. The functions are different.

The social security card not only has the function of a medical insurance card, but also an important document for handling various social security services, such as receiving unemployment benefits.

The medical insurance card is limited to the function of medical insurance, and can only be used to enjoy the medical insurance treatment of the trembling tour.

3. The card issuing department is different.

The medical insurance card is undertaken by the local designated ** bank.

Social security cards are issued to the public by local human resources and social security departments.

4. The safety performance is different.

The social security card has a relatively strict key management system and approval, and the security factor is high. The medical insurance card does not have this management system, and some of the password-free cards can be used without entering the payment password, and the security factor is low.

5. The scope of inclusion is different.

The full name of social insurance is social insurance, which includes endowment insurance, medical insurance, unemployment insurance, work-related injury insurance and maternity insurance. Medical insurance only refers to the medical insurance in the grinding social security.

6. Accounts are different.

The social security card has three accounts, including a medical insurance account, a pension account, and a financial account. A health insurance card is a health insurance account.

Supplementary medical insurance is relative to basic medical insurance, it is a kind of supplementary insurance, including enterprise supplementary medical insurance, commercial medical insurance, social mutual aid and community medical insurance and other forms, is a supplement to basic medical insurance, but also an important part of the multi-level medical insurance system. There is both a connection and a difference between the two.

The difference between them is whether they are mandatory or not. Basic medical insurance is mandatory, while supplementary medical insurance is not enforced by China's legislation, and is voluntarily participated by employers and individuals. After the unit and employees participate in the unified basic medical insurance, the unit or individual can appropriately choose to increase the medical insurance items according to their own needs to improve the guarantee level of individual medical insurance.

The connection lies in the fact that the two complement each other, and both aim to provide medical insurance for employees, play a role in stabilizing society and promoting development.

Expansion: What is the standard of individual medical insurance payment in Hangzhou?

In the medical insurance individual payment. Other urban and rural residents' medical insurance is divided into two levels, and the insured can choose to participate in the insurance according to their own situation:

1) Level 1: The medical premium is 700 yuan per year for individuals;

2) Second level: The medical insurance premium is 600 yuan per year for individuals.

The medical premiums payable by the authorities are fully subsidized by the authorities for those who have the following two conditions:

1. Holders of the "Certificate of Assistance and Support for Persons in Extreme Poverty", "Family Certificate of Minimum Birth Guarantee", "Basic Livelihood Guarantee for Disabled Persons" issued by the Department of the Disabled Persons' Federation of the Municipality within the validity period, or the "Certificate of Disabled Persons of the People's Republic of China" issued by the Disabled Persons' Federation of the People's Republic of China within the validity period;

2. Those who have been adopted by social welfare institutions, children's welfare institutions and other institutions in Hangzhou and individuals who enjoy regular bereavement allowances.

In addition, individuals who hold the "Minimum Life Insurance Marginal Family Certificate" shall be subsidized by half of the medical premiums for urban and rural residents.