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a, the characteristics of the health insurance
1, the scope of protection
All employers and employees, whether state organs, business units, or private enterprises, individual workers, are within the scope of the basic medical insurance.
2. Medical Expenses ****Bearing
The medical expenses of the insured are reimbursed by the integrated fund on a proportional basis. Therefore, the medical expenses of the insured are shared by the local government, the insured organization and the insured***.
3, can be insured with the disease
Medicare does not have the health information this link, whether in the past or now there is no disease, suffered from what disease, can be insured normally, but also can be normal reimbursement.
4. Long-term validity after the expiration of the contribution period
After the expiration of the statutory contribution period of the employee health insurance, you can continue to enjoy the protection of the health insurance after retirement without paying a penny.
5. Compulsory participation
The state stipulates that all urban employers and employees must participate in health insurance.
The shortcomings of medical insurance
Medical insurance is very good in terms of reimbursement ratio, reimbursement amount or protection. But is it really enough to just buy health insurance? Milkman's answer is not enough.
1, medical reimbursement is limited
Medicare has three major catalogs of drugs, diagnostics, and services, and those not in the catalogs are not reimbursed. The same applies to myopic surgery and mental illnesses. There are also some special drugs for major diseases and high-tech examination and treatment equipment that are not in the catalog and cannot be reimbursed.
2, involving third-party liability is not reimbursed medical expenses refers to the work-related injuries suffered by employees or occupational diseases for treatment, rehabilitation treatment, injured workers in the period after the expiration of the period of leave of absence from work still need to carry out treatment, as well as injured workers recurrence of injuries to confirm the need to carry out medical treatment, in the signing of a service agreement of the health care institutions to seek medical treatment (except in case of emergency), the cost of medicines, surgery and other treatment costs, because these costs are the work of the workers, the cost of treatment, the cost is not reimbursed. The medical, surgical and other treatment costs incurred in the medical institutions under the service agreement (except in case of emergency), which are the direct consequence of the work injury and the main purpose of the work injury insurance system, should naturally be entitled to the medical treatment of the work injury and be paid out of the Work Injury Insurance Fund.