Study on Overall Medical Insurance for Serious Illness in Beijing
In order to better protect their health, people began to pay attention to critical illness insurance. At present, there are many kinds of health insurance products on the market, and the national health insurance policy is also being actively implemented, including the overall planning of serious illness in Beijing. The formulation of serious illness co-ordination follows the principle of "minor illness diversion and serious illness co-ordination", that is, a deductible line is set, ranging from several hundred yuan to several thousand yuan, depending entirely on the local economic affordability and medical treatment level. The medical expenses below the deductible line shall be borne by individual employees, and the part above the deductible line shall be paid by social insurance institutions in proportion.
First, the principle of serious illness as a whole
The principle of pooling the amount of serious illness is to ensure basic medical care and overcome waste; Mutual assistance, risk * * *; The state, enterprises and individuals should bear the burden reasonably.
Second, the scope of the master plan.
The medical expenses incurred by employees and retirees in one-time hospitalization due to illness or non-work-related injuries or the accumulated medical expenses within 30 days exceed 2,000 yuan, which belongs to the scope of overall planning. However, the medical expenses under any of the following circumstances do not belong to the scope of overall planning:
1. The injury caused by my violation of the law.
2. Suffering from occupational diseases, work-related injuries or recurrence of old injuries;
3. Being treated in a non-designated hospital without approval (except for emergency rescue);
4. Treatment for suicide (except psychotic episode);
5. Injuries caused by traffic accidents;
6 according to the provisions of the state and the city should take care of their own medical expenses;
7. Food poisoning caused by accidents;
8. Injuries caused by medical accidents.
It should be noted that the proportion and scope of reimbursement for serious illness are very different from that of basic medical insurance. The proportion of reimbursement for serious illness will vary according to the insurance cost and age, and the insured person needs to go to the designated hospital or specialized hospital for medical insurance to obtain medical reimbursement.
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20 17 interpretation of the new rural cooperative medical system's overall planning policy for serious diseases
The new rural cooperative medical system, referred to as the "new rural cooperative medical system", refers to the farmers' medical mutual aid system organized, guided and supported by the government, in which farmers voluntarily participate and individuals, collectives and the government jointly raise funds. The following is my interpretation of the 20 17 NCMS serious illness co-ordination policy. Welcome to reading.
Definition and limitation of overall medical insurance for serious illness
Overall medical insurance for serious illness is a model of medical insurance in China. Due to the limited conditions, it can only be realized at the municipal level. Different parts of the country have different approaches to this system. "I have already got medical insurance in the company. Do I still need to invest in medical insurance for serious illness?" This is Zhang Li's problem. He has just been assigned to work in a state-owned enterprise. Indeed, in our real life, there are not a few people who have similar questions.