Medical insurance is divided into three grades, the first grade is the best and the third grade is the worst.
The specific differences are as follows:
The personal account of the first insured person is used to pay the medical expenses within the scope of the general outpatient medical insurance catalogue of the insured person. Community health center basic medical expenses personal account to pay 70%, the overall fund to pay 30% in accordance with the provisions.
Second-class insured; Three types of insured persons, belonging to Class A drugs and Class B drugs, are paid by the community outpatient co-ordination fund according to the proportion of 80% and 60% respectively; 90% of the single diagnosis and treatment or medical materials belonging to the medical insurance catalogue shall be paid by the community outpatient co-ordination fund, but the maximum payment amount shall not exceed 120 yuan; The total outpatient medical expenses paid by the community outpatient co-ordination fund to each second-grade and third-grade insured within a medical insurance year shall not exceed 1000 yuan.
Social medical insurance is a social insurance system established by the state and society according to certain laws and regulations to provide basic medical needs for workers within the scope of protection. It is undertaken by the government and implemented and managed by economic, administrative and legal means.
Social medical insurance consists of basic medical insurance and large medical assistance, enterprise supplementary medical insurance and individual supplementary medical insurance.
Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the contributions of employers and individuals. After the insured person has medical expenses, the medical insurance institution will give certain economic compensation.
legal ground
People's Republic of China (PRC) social insurance law
Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations. Twenty-ninth medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by the social insurance agency, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.