Exceeding the scope of basic medical insurance

How to deal with medical expenses after exceeding the scope of basic medical insurance When medical expenses exceed the scope of basic medical insurance, individuals are responsible for the excess costs. Basic medical insurance usually covers basic medical expenses, hospitalization expenses, outpatient expenses, etc., but the exact scope and limit may vary by region and policy. Costs that are beyond the scope of basic medical insurance may include some high treatment costs, imported medicine costs, special examination costs, etc.

One solution is to purchase commercial medical insurance to make up for the shortcomings of basic medical insurance. Commercial medical insurance can usually be chosen according to an individual's needs and budget, and can offer a wider range of coverage and higher benefit limits. When purchasing commercial health insurance, individuals need to read the insurance contract carefully to understand the specific terms and limitations of the coverage.

Alternatively, individuals may choose to accumulate an emergency reserve or establish a medical reserve account to cover possible medical expenses beyond what is covered by basic medical insurance. The reserve or reserve account can be a portion of an individual's savings or funds acquired through investment banking.

Basic medical insurance covers outpatient and emergency care, inpatient hospitalization, and major medical assistance. Specifically, the scope of basic medical insurance coverage varies by region and policy, but usually includes medical expenses in the following areas:

1. Hospitalization expenses: These include medical expenses incurred during hospitalization, such as surgical fees, medication, and nursing care.

2. Outpatient expenses: including expenses incurred for outpatient diagnosis, examination and treatment.

Drug costs: including the costs of drugs in the basic medical insurance drug catalog.

3. Diagnostic and therapeutic program costs: including costs incurred by some specific examination and treatment programs, such as nuclear magnetic **** vibration, dialysis, etc.

4. Large medical expenses: including medical expenses exceeding a certain limit, such as high cost of treatment, imported drugs.

It should be noted that the payment scope of basic medical insurance usually has limitations and regulations, such as a certain starting and capping line, and some special treatments and medicines may be excluded from the payment scope. Therefore, while enjoying the basic medical insurance, individuals also need to bear a certain amount of medical expenses.

In summary:

When medical expenses exceed the coverage of basic medical insurance, individuals can choose to purchase commercial medical insurance, accumulate emergency reserves or set up a medical reserve account to deal with the excess. These measures can help individuals reduce their financial burden when faced with high medical expenses and ensure access to necessary medical services and treatment.

Legal basis:

Article 30 of the Social Insurance Law of the People's Republic of China*** and the People's Republic of China stipulates, "The social insurance fund shall pay for medical expenses in accordance with the nationally stipulated list of medicines for basic medical insurance, medical service items, and standards for medical equipment and facilities." This means that the scope of payment for basic medical insurance is limited and is required to be paid in accordance with state regulations. Medical expenses beyond the prescribed scope will be borne by individuals themselves.

Meanwhile, the People's Republic of China*** and the State Insurance Law also regulates the contract terms and insurance liability of commercial medical insurance. Individuals should follow the relevant laws and regulations when purchasing commercial medical insurance and carefully understand the specific terms of the insurance contract.