Medical insurance generally reimburses the insured for medical expenses due to diseases or accidents, but the expenses incurred by nursing workers do not meet the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards, and they cannot enjoy medical insurance reimbursement.
The significance of medical insurance reimbursement lies in:
1, Reduce the burden of medical expenses: By reimbursing part or all of the medical expenses, the financial pressure of the insured can be reduced, especially for patients with serious illness or chronic diseases, medical insurance reimbursement can greatly reduce the personal burden.
2. Promote the rational use of medical and health resources: The medical insurance reimbursement system guides the insured to seek medical treatment reasonably by setting the deductible line and reimbursement ratio, avoiding excessive medical treatment and waste, and also encourages medical institutions to provide high-quality and low-cost services.
3. Maintaining social equity: medical insurance reimbursement reflects the fairness of social security, and everyone, rich or poor, should enjoy basic medical security. Reimbursement of medical expenses can narrow the gap between the rich and the poor and maintain social stability.
4. Improve the level of disease prevention and treatment: the scope of medical insurance reimbursement is gradually expanded, including more expensive medical treatment items and drugs, which will help improve the level of disease prevention and treatment and promote the progress of medical technology.
5. Promote the development of health insurance system: With the expansion of the scope of medical insurance reimbursement and the increase of reimbursement ratio, people's confidence in medical insurance has gradually increased, and their enthusiasm for participating in insurance has increased, thus promoting the development of health insurance system.
To sum up, medical insurance reimbursement is of great significance to individuals and society, which protects people's health rights and interests, reduces the economic burden, promotes the rational use of medical and health resources, and maintains social fairness and stability.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, 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.