Let's take commercial medical insurance and social medical insurance as examples to explain why social insurance cannot replace commercial insurance.
1, differences in security content
The insurance liability of commercial medical insurance is greater than that of social medical insurance. For example, the coverage of social medical insurance does not include the examination and treatment items using large medical equipment such as electron beam CT and ophthalmic excimer laser therapeutic apparatus, while the coverage of commercial medical insurance can include the expenses incurred by using these large medical equipment for examination and treatment.
As shown in the figure below, the types of drugs that can be reimbursed by social security are also very limited. For example, in cancer treatment, there are many targeted drugs with relatively small side effects and high curative effect, but these specific drugs are very expensive. For example, Kelida, which treats lung cancer, costs more than 50,000 yuan per month. However, this medicine belongs to social security medicine. Without commercial insurance, most cancer patients can't afford these specific drugs.
2. The reimbursement amount is different.
Because of its welfare, social security has a relatively low premium, and its security and reimbursement scope are also relatively low. For off-site treatment, even if it can be reimbursed, the reimbursement ratio will be discounted again, and the reimbursement ratio of commercial medical insurance will usually not change because of off-site treatment. Therefore, social medical insurance may be enough to meet the expenses of minor illnesses, but it is not enough to face serious illnesses. As shown in the figure, more than half of the medical expenses and less than 50% of the social security reimbursement.
For other analysis on the differences and connections between commercial insurance and social security, please refer to how to use social security medical insurance. 1. Teach you how to apply for reimbursement!