Can good medical insurance and medical insurance be reimbursed at the same time?

Good health insurance. It can be reimbursed at the same time as medical insurance, which is generally reimbursed through medical insurance first, and then reimbursed through good medical insurance. The two can only reimburse the actual medical expenses that meet the requirements, that is, the total amount of reimbursement does not exceed the actual medical expenses incurred, and the same medical expenses cannot be reimbursed repeatedly.

Social security. The medical insurance is in accordance with the laws and regulations of the state and society.

A social insurance system that meets the basic medical needs of workers in the event of illness.

Extended information: Supplementary medical insurance is relative to basic medical insurance, including supplementary medical insurance for enterprises.

Commercial medical insurance, social mutual aid and community medical insurance are a powerful supplement to basic medical insurance and an important part of the multi-level medical security system. Unlike basic medical insurance, supplementary medical insurance is not enforced through national legislation, but is voluntarily participated 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 and supplementary medical insurance are not contradictory, but complementary and irreplaceable, and their purpose is to provide medical protection for employees.

The goal of the reform of China's medical insurance system is to realize a multi-level medical insurance system. Therefore, the state encourages enterprises to establish a supplementary medical insurance system to ensure that the level of medical insurance treatment for employees of the enterprise is not reduced. The specific regulations are:

Participate in various social insurances in accordance with regulations and pay social insurance premiums in full and on time.

can decide whether to establish supplementary medical insurance. Supplementary medical insurance** is used for enterprises to participate in local basic medical insurance according to regulations, and the basic medical insurance system for urban employees.

In addition to the benefits paid, appropriate subsidies for medical expenses borne by the employees themselves will reduce the burden of medical expenses on the insured employees. Enterprise supplementary medical insurance premiums in the gross salary.

The part within 4% 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. Enterprise supplementary medical insurance funds by the enterprise or industry centralized use and management, separate accounts, separate management, for the enterprise personal burden of heavier workers and retirees of medical subsidies, shall not be assigned to the basic medical insurance personal account, shall not be established in a separate personal account or disguised for other aspects of the staff expenditure.

The financial department and the labor and social security department should strengthen the supervision and financial supervision of the management of supplementary medical insurance funds of enterprises, and prevent misappropriation of funds and other violations.

Good medical insurance can be used together with medical insurance, but you need to use good medical insurance for reimbursement after the medical insurance reimbursement, if you do not use medical insurance for reimbursement first, then according to the contract, good medical insurance will only reimburse 60%.

For example, if the insured spent 50,000 yuan on hospitalization**, and the annual deductible of good medical insurance is 10,000 yuan, if the insured did not use medical insurance for reimbursement first, then the insurance money that the insured can get is (50,000-10,000) 60% = 24,000 yuan, and after the reimbursement of medical insurance, medical insurance reimbursement (reimbursement ratio of 60%), then the final total reimbursement amount is (26,000 60%) + 24,000 yuan = 39,600 yuan.

If the insured first uses medical insurance for reimbursement, for example, 30,000 yuan (reimbursement ratio of 60%) yuan is reimbursed by medical insurance, then the final reimbursement amount of the insured is +30,000 = 40,000 yuan.

Therefore, the insured should be reimbursed for medical insurance first, and then use medical insurance for reimbursement after medical insurance reimbursement.

It can be reimbursed at the same time. After people get sick**, they will be reimbursed through medical insurance first, and then the medical insurance will reimburse the remaining part of the medical insurance reimbursement according to the provisions of the contract. However, if the medical insurance has a deductible, then it is necessary to remove the deductible first, and then reimburse the remaining expenses according to the reimbursement ratio.

If a person has both health insurance and medical insurance, most of the medical expenses can be reimbursed. After all, the drug list of medical insurance is more extensive than that of medical insurance, so it can be improved and made up for the shortcomings under the premise that social insurance provides basic protection.

Legal Analysis: Reimbursement cannot be made at the same time. The two belong to different medical security systems, and only one of the two can be chosen, as for which reimbursement is more cost-effective, it depends on the reimbursement amount.

Legal basis: Social Insurance Law of the People's Republic of China

Article 2: The State shall establish social insurance systems such as basic pension insurance, basic medical group deficiency insurance, work-related injury insurance, unemployment insurance, and maternity insurance, to ensure citizens' right to receive material assistance from the State and society in accordance with law in the event of old age, illness, work-related injury, unemployment, childbirth, and so forth.

Article 26 The treatment standards of basic medical insurance for employees, new rural cooperative medical care and medical insurance for urban residents shall be implemented in accordance with the provisions of the State.

Article 28 In line with the basic medical insurance drug list, diagnosis and treatment items, medical service facility standards and medical expenses, emergency and rescue medical expenses, in accordance with the provisions of the State from the basic medical insurance **.

Medical insurance is divided into expense reimbursement type and fixed allowance type

Subsidized health insurance is an additional compensation for medical expenses, such as a supplement for the number of days of hospitalization. This type of benefit is only related to the number of days of hospitalization, and has nothing to do with the incurrence of medical expenses. If the customer has purchased a fixed rate benefit from more than one insurance company.

After the accident, the customer will be compensated according to the insurance contract according to the liability, and the compensation of each insurance company will not be affected by the medical expenses incurred.

Expense compensation insurance is a form of medical expense reimbursement protection, that is, the amount of insurance payment will not exceed the actual medical expenses, even if multiple medical insurances are purchased at the same time, the total insurance paid by multiple insurance will not be more than the actual medical expenses incurred, that is, it will not be greater than 100% of the medical expenses.

When purchasing medical insurance, you need to first consider purchasing cost-compensatory benefits, and then purchase subsidy-type benefits as a supplement. Nowadays, medical and social security insurance are very popular, and he is perfect. It is important to know a little more about medical care and choose the right insurance coverage for you.

Good medical insurance hospitalization and long-term medical care, if there is no fixed allowance, it is equivalent to buying duplicates.

But there is a caveat:

1. Some medical insurance can be used regardless of accident and illness, but some medical insurance only covers the medical treatment of diseases, so it depends on how the contract is agreed.

2 Some medical insurance is 100% payout, while most are pro-rated. Look at the contract.

3. Some medical insurance is only within the scope of medical insurance, and the imported drugs are not reimbursed.

4. Medical insurance generally has a deductible.

Good medical insurance inpatient medical treatment generally has a deductible of 10,000 yuan, so medical treatment within 10,000 yuan cannot be used by good medical insurance at all, and long-term medical treatment can just be used. However, the reimbursement ratio of the insured amount for long-term medical treatment is too low; Good medical insurance can be as high as one million. So these two medical insurances are actually complementary to each other.

If you don't understand something, you can ask.

Give it a good review.

Good medical insurance long-term medical care and long-term medical care can be bought at the same time, but the coverage of good medical insurance hospitalization medical treatment and good medical insurance long-term medical care is almost the same, so this also means that after the insured uses the full reimbursement of good medical insurance long-term medical care, he can no longer use good medical insurance inpatient medical treatment for reimbursement.

Of course, if the money spent is not fully reimbursed through good medical insurance long-term medical care, then the remaining expenses can still be reimbursed by good medical insurance inpatient medical treatment.

There are also detailed information about inpatient medical care, which can be found here: "Good Medical Insurance Inpatient Medical Evaluation, a medical insurance for hospitalization**!" 》

Good medical insurance long-term medical care and good medical insurance inpatient medical care are both reimbursement insurance, which only reimburses the expenses actually incurred by the insured.

The coverage of good medical insurance hospitalization and good medical insurance long-term medical care is almost the same, so this also means that after the insured uses the good medical insurance long-term medical care for full reimbursement, he can no longer use good medical insurance inpatient medical treatment for reimbursement.

For more information about inpatient medical care, please see here: "Good Medical Insurance Inpatient Medical Evaluation, a medical insurance for hospitalization**!" 》

Basic medical insurance and insurance company insurance are different insurance contents, and company reimbursement is another unit benefit (generally after participating in social basic medical insurance, the company reimbursement is a supplementary medical insurance).

Social medical medical insurance: is a kind of national basic medical insurance, hospitalization expenses in addition to the provisions can not be reimbursed or self-care expenses usually reimbursed 60 to 80 percent (the implementation of the situation is different, the new rural insurance and urban workers basic medical insurance is also different).

Unit reimbursement is a kind of welfare implemented by the unit itself, it is based on the previous implementation of labor insurance, with the implementation of social basic medical insurance, many units have been canceled but the national policy allows the implementation of supplementary medical insurance, this supplementary insurance will be reimbursed for a certain amount of self-care part of the social medical insurance, but this is only the welfare of the unit, not the system that must be implemented.

We're glad to be able to answer this question for you. Good medical insurance is not a hospitalization report, and the reimbursement of good medical insurance hospitalization must meet the following requirements: 1. Within the protection responsibility.

Hospitalization expenses that are not covered by the coverage cannot be reimbursed. 2. After the waiting period. Medical expenses incurred during the waiting period will not be reimbursed, except for hospitalization caused by accidents.

3. The part that exceeds the deductible. Good medical insurance has a deductible of 10,000 yuan, and the part of self-payment exceeding 10,000 yuan can be reimbursed after being reimbursed by social security, and the part of the celery bureau that spends more than 10,000 yuan without social security can be reimbursed. 4. Spend reasonable and necessary hospitalization expenses in a recognized hospital.

The hospitals recognized by the Good Medical Insurance are the general departments of public hospitals of the second level and above. 5. Circumstances that do not fall under the disclaimer clause. The exemption clause stipulates that the hospitalization expenses caused by the situation of the negotiation orange will not be compensated by the good medical insurance.