I. Medical insurance can be divided by system:
1. Indirect medical insurance system: the government social insurance agency and private medical institutions signed a contract, the patient pays for their own medical expenses, and then reimbursed in whole or in part to the social insurance agency. This system is more common in western industrialized countries.
2. Direct medical insurance system: the government directly owns and manages the medical institutions, and bears all or part of the workers' medical expenses. This system is more common in socialist countries.
3, basic health care: that is, preventive, curative and comprehensive health insurance services. It includes nutritional improvement, sanitation and water supply, maternal and child health care, immunization against major infectious diseases, prevention and control of epidemics, and treatment of common diseases. Such systems are common in developing countries. The conditions for entitlement to health insurance should be determined on the basis of the number of years of employment or the payment of insurance premiums. Generally, those who are entitled to cash subsidies for sickness insurance are entitled to medical care.
Two, medical insurance payment methods:
1, basic medical insurance
Basic medical insurance premiums are collected by the local tax department, and the contributing units and individuals pay in full from what are the methods of medical insurance payment to what are the methods of medical insurance payment on the 0th day of each month. The basic medical insurance premiums paid by the county's fully-funded organs and institutions are directly transferred in full by the county treasury on a monthly basis, while other basic medical insurance premiums are collected by the county local tax department on a monthly basis according to the collection plan provided by the county medical insurance agency. The portion paid by individual employees is withheld by the employer from their wages.
2. Supplementary Medical Insurance for Major Diseases
Supplementary medical insurance premiums for major diseases are collected by the county medical insurance agency, and the employer pays a lump sum before the end of the month of each year in what ways are the contributions for medical insurance.
Third, the individual basic medical insurance premium payment:
First of all, the coordinating area to determine a suitable level of burden of the local workers individual basic medical insurance contribution rate, generally 2% of the wage income, the conditions of the region can also be appropriate to increase the proportion of individual contributions.
Second, by the individual to their salary income as a base, according to the local individual contribution rate to pay basic medical insurance premiums. In the individual contribution base, it should be pointed out that it is not according to my basic salary or standard salary as the base, but according to the statistical caliber of wage income as the base, that is, all the wage income, including all kinds of bonuses, labor income and in-kind income and all wage income as the base, multiplied by the required individual contribution rate, that is, the basic medical insurance premiums payable by the individual.
Thirdly, individual contributions are generally not required to be paid by the individual at the social insurance agency, but are withheld and paid by the unit from the wage income.
Hospitalization medical insurance, like comprehensive medical insurance, is part of social insurance medical insurance. If an insured person buys hospitalization medical insurance, the expenses incurred by the insured person for hospitalization after an accident are usually covered by the insurance company.
Legal basis:
The Law of the People's Republic of China on Basic Medical Care and Health Promotion
Article 5: Citizens shall enjoy, in accordance with the law, the right to obtain basic medical care and health services from the state and society. Medical and health institutions of all types and at all levels shall divide up their work and provide citizens with a full range of all-cycle medical and health services, such as prevention, health care, treatment, nursing care, rehabilitation, and hospice care.
Chapter 8 of the Outline of the "Healthy China 2030" Plan, entitled "Providing high-quality and efficient medical services," calls for the realization of equal basic medical and health services for all, and the strengthening of rehabilitation, geriatrics, long-term care, and chronic disease management, The Outline calls for: realizing equal basic medical and health services for all; strengthening the construction of follow-up medical institutions for rehabilitation, geriatrics, long-term care, chronic disease management, and hospice; realizing the integration of medical care and prevention; and improving the treatment-rehabilitation-long-term care service chain.