What is the difference between commercial medical insurance and medical insurance?

Xueba talks about insurance, focusing on insurance evaluation! If you want to buy medical insurance, I recommend you take a look at this comparison table:"Super Complete! Comparison Table of Popular Million Medical Insurance in China

If you need to buy medical insurance products, it is recommended that you give priority to buying millions of medical insurance, which is very cost-effective, and you can get millions of protection for a few hundred yuan. At the same time, its coverage is also very comprehensive, such as surgery fees, examination fees, hospitalization fees and so on.

When we buy million medical insurance, in addition to looking at the protection liability, **, exemption clauses, renewal clauses and other conventional content, we should also pay attention to the "stability of sustainable insurance".

In terms of renewal, it should be noted that medical insurance can only be purchased for a short period of time, so it is often encountered that the insurance is successfully applied for in the first year, but there is no way to renew the insurance in the second year, because there is a little problem in the body during the year. Medical insurance like these has a big deficiency in renewal:

"When encountering these medical insurances, please be careful and be careful! 》

The stability of sustainable insurance is, simply put, whether the product will be discontinued, which only the insurance company itself knows. Generally speaking, we can judge from these aspects: whether the sales volume is large, whether there are enough healthy individuals to join, whether it is reasonable, the conditions of the insurance company, etc.

In addition, this point should also be noted, most of the products, if people who have not purchased social security are insured, the premium will be more expensive, so social security should be paid well

That's what I have to say about this issue, and I hope it helps.

The rest of the reimbursement can be continued to be reimbursed by commercial insurance.

1. Medical insurance.

The basic attributes of commercial medical insurance are different. Social medical insurance is social insurance.

is mandatory. It is related to basic endowment insurance, work-related injury insurance, unemployment insurance, and maternity insurance.

and so on together constitute the modern social insurance system. The basic employee medical insurance is jointly paid by the enterprise and the individual in accordance with the prescribed proportion. Medical insurance for urban and rural residents.

The individual pays the fee, and the state gives a certain fee subsidy. Commercial medical insurance is of a commercial nature, the insured is based on voluntary insurance, the cost is all paid by the individual, and some enterprises have good benefits, will increase the benefits of employees, enough to buy commercial medical insurance.

2. The insurance coverage of medical insurance and commercial medical insurance is different. The insurance coverage of social medical insurance is relatively large, not only for "serious illness", but also for "minor illness", and the hospitalization expenses of the insured will also be compensated to a certain extent, and the outpatient expenses can also be reimbursed. However, the insurance coverage of commercial medical insurance is relatively small, and usually only the hospitalization expenses of the diseases covered by it are paid according to the provisions of the contract.

3. The insurance benefits of medical insurance and commercial medical insurance are different. Social medical insurance usually compensates according to a certain proportion of medical expenses, and the amount is fluctuating, not completely based on the insurance premiums paid by individuals, and has the nature of social assistance; Commercial medical insurance is usually based on a certain amount of compensation, and the compensation amount is fixed or within a certain range, and this type of insurance is generally the principle of the majority of the insurance company's reference insurance.

to specific operations, with the nature of commercial relief.

Test your anti-risk index, experts will interpret it for you for free!

The full name of medical insurance is basic medical insurance, which is a kind of social insurance system, and is the state's first-class welfare insurance, which is used to basically solve medical problems. Commercial medical insurance is an insurance contract voluntarily concluded with an individual and an insurance company, and the insurance premium is paid on time, and when a possible disease occurs, the insurance company will assume the relevant responsibility for paying the insurance money according to the insurance contract.

Social Insurance Law: Article 23 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 prudent employees, part-time employees who have not participated in the basic medical insurance for employees and other flexibly employed persons can participate in the basic medical insurance for employees, and the basic medical insurance premiums shall be paid by the individual in accordance with the provisions of the state.

Article 25 The State shall establish and improve the basic medical insurance system for urban residents. The basic medical insurance for urban residents implements a combination of individual payment and subsidy. Those who enjoy the minimum living guarantee, the disabled who have lost the ability to work, the elderly over the age of 60 from low-income families, and minors who need to pay the part of the individual contributions shall be subsidized by **.

Article 27 Individuals who participate in the basic medical insurance for employees and reach the statutory retirement age and whose cumulative contributions reach the number of years prescribed by the state shall no longer pay the basic medical insurance premiums after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state; If the number of years prescribed by the state has not been reached, the fee can be paid until the number of years prescribed by the state. Article 28 Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards, as well as emergency and rescue medical expenses, shall be paid from the basic medical insurance in accordance with national regulations. Article 29 The part of the medical expenses of the insured persons that should be paid by the basic medical insurance** shall be directly settled by the social insurance agency and the medical institution and the drug business unit.

The administrative department of social insurance and the administrative department of health shall establish a system for the settlement of medical expenses for medical treatment in other places to facilitate the insured persons to enjoy basic medical insurance benefits.

1. Led by the first and provided by the insurance company; **A kind of people's welfare with low and high insurance amount.

It has its own limitations, such as:

1) There is a starting line under and a cap line on it.

The medical insurance only supports the reimbursement of medical expenses within the scope of the designated hospitals and social security catalogs, and the starting line is generally more than 300-1800, and the maximum limit can only reimburse 320,000 outpatient and inpatient expenses.

So, if you exceed the maximum limit, if you don't have enough of the minimum limit, you will have to pay for it yourself!

2) There is a limit to the scope of reimbursement, and not all cases can be reimbursed.

Although social security is a welfare, it does not manage everything. Things like plastic surgery, vision correction, traffic accidents, medical malpractice, and even being stabbed by gangsters are not covered by medical insurance.

Because none of these conditions are pathological causes, and there is a recoverable liability for the person responsible, this kind of risk can only be passed on with other products such as accident insurance.

In addition, there is also a self-payment ratio of about 15% for this part that can be reimbursed, which also needs to be paid by yourself.

3) There are restrictions on the use of drugs, and many imported drugs have to pay for them out of their own pockets.

Drugs and medical items that are not included in the social security drug list cannot be reimbursed, such as imports, special drugs and ventilators, ICU ward nursing fees, etc. What is the Social Security Drug List?

At present, there are more than 100,000 kinds of drugs on the market in China, which are divided into three categories: A, B and C.

Class A is widely used, cheap, and can be 100% reimbursed.

Category B drugs will be more effective than the same type of Class A, but more expensive, and the reimbursement rate is about 80%.

If you unfortunately have cancer, most of the imported special drugs, such as the targeted drugs on the market in recent years, can only pay for them. Therefore, there are only about 3,000 kinds of drugs in the social security drug catalog. Moreover, different types of medical insurance, the list of social security drugs in different regions is also different.

4) If you guess that Buqin has a major disease, such as spike malignant tumor, liver and kidney disease, and lung disease, then the hospitalization medical expenses and special drug expenses incurred after the insurance will not be compensated. However, for other diseases, Huimin Insurance can still be reimbursed.

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The difference between commercial insurance and medical insurance is as follows:

Different coverages: Commercial insurance covers a relatively small scale. Generally, there is only a certain amount of reimbursement for hospitalization expenses, and Medicare will reimburse the insured person for state illnesses listed in the medical insurance list, including outpatient treatment.

The basic attributes of the two are different: compulsory social medical insurance is a compulsory public welfare welfare undertaking, and all employers must participate in the insurance in accordance with the law. Commercial medical insurance is commercial in nature and is not mandatory.

Different premiums: medical insurance premiums are relatively low, usually a few hundred yuan can be guaranteed accordingly, commercial medical insurance usually has higher premiums, and the guarantee period can be selected according to your own situation.

There are two classifications of medical insurance, national medical insurance and commercial medical insurance

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2) Commercial medical insurance lotus peach when o exhibition bag stirring ticket o blink before the green onion Dong! Sheng ticket u rare.

National medical insurance is the basic welfare given by the state to everyone, and it is recommended that everyone participate in insurance. Commercial medical insurance is suitable for those who want better and more comprehensive protection, or want to reimburse self-financed drugs and imported drugs, and can choose to supplement commercial medical insurance. In particular, the elderly and children have a higher risk of illness and accidents, and should pay more attention to medical protection.

After all, medical insurance covers a large number of people in the chain, so the protection is relatively basic, there will be restrictions on the social security catalog, and many expenses cannot be reported, such as imported drugs, self-financed drugs, etc., but they can be reimbursed through commercial medical insurance.

Commercial insurance has a wide range of coverage, including health insurance, financial insurance, and some car insurance. Medical insurance is a part of our social envy bridge sales insurance, and it is the basic welfare of every worker.

The commercial insurance corresponding to medical insurance is million medical insurance and critical illness insurance, let's talk about it briefly.

Let's first talk about the difference between medical insurance and million medical insurance, although they are all medical insurance in the mouth, but there is still a big difference in comparison.

Medical insurance is the abbreviation of medical insurance in five insurances and one housing fund, and the basic benefits of workers are to be paid, which is generally paid by enterprises and employees according to a certain base.

Serious and minor illnesses and outpatient surgeries in ordinary life can be reimbursed through medical insurance, and some areas that participate in medical insurance can also apply for local urban Huimin Insurance.

However, the reimbursement ratio and medical insurance drugs in different regions are different, and the local reimbursement and remote reimbursement are different, so you need to pay attention to local policies.

Million medical insurance is one of the types of commercial insurance, because the insured amount is as high as one million, it is vividly called million medical insurance.

The protection period of million medical insurance is relatively short, generally limited to one year, and it needs to be re-insured after expiration, and it is also a product that can be renewed to provide the insured with stable protection for a period of time.

The main coverage of Million Medical Insurance includes inpatient medical treatment, special outpatient, outpatient and emergency travel before and after hospitalization, and outpatient surgery, and the reimbursement ratio depends on the product amount.

Inpatient medical treatment generally includes bed fees, drug fees, ** fees, surgery fees, diagnosis and treatment fees, etc., and the medical expenses of inpatient maternity and consumption are covered.

Special outpatient clinic refers to the ** used for major diseases, such as outpatient kidney dialysis**, outpatient malignant tumors**, rejection after organ transplantation**, etc.

The outpatient and emergency services before and after hospitalization mainly refer to the medical expenses incurred by the outpatient and emergency departments for the same reason as the hospitalization, including the cost of outpatient examinations and diagnoses, which are generally seven days before and after.

Outpatient surgery refers to the cost of performing surgery on an outpatient basis, which can be reimbursed.

A comprehensive million medical insurance, the protection content will include the above protection content, we should pay attention to distinguish when choosing a specific product.