(1) Expense-based hospitalization medical insurance, that is, the policyholder through the basic social medical insurance reimbursement of part of the medical costs, the insurance company in accordance with the principle of compensation for the loss of insurance, compensation for the policyholder spent the remainder of the medical costs;
(2) subsidized hospitalization medical insurance has nothing to do with the actual cost of medical care, claims do not need to provide invoices, the insurance company in accordance with the contractual subsidy standards for the policyholder to pay compensation. The insurance company pays out to the insured according to the subsidy standard stipulated in the contract. For families without social security, it is recommended to take out expense-based hospitalization medical insurance.
2. The cost items of the hospitalization medical insurance are mainly the daily hospital fee (bed fee), the cost of using the hospital equipment, the cost of surgery, the cost of medicine, etc. The length of the hospitalization will directly affect the cost of the hospitalization. The length of the hospitalization period will have a direct impact on the cost, so the amount of this insurance should be based on the patient's average hospitalization costs. It is usually stipulated that the insurer is only responsible for a certain percentage of all the costs, not the entire amount. There is usually an observation period associated with the purchase of hospitalization health insurance. An observation period is a period during which the insurance company does not have to pay for any hospitalization medical expenses incurred by the client. The observation period varies from one insurance company to another, from one month to 60 days to 90 days.
Social Insurance Law
Article 28 Medical expenses that conform to the basic medical insurance drug list, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergency and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.
Article 29 The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly by the social insurance administrative organization with the medical institutions and drug business units. The social insurance administrative department and the health administrative department shall establish a settlement system for medical expenses for medical treatment in other places, so as to facilitate the enjoyment of basic medical insurance treatment by insured persons.