Outpatient:
Basic medical third grade and basic medical second grade have 1000 yuan outpatient expenses per year, but must be in the bound social welfare hospitals in order to enjoy, the basic medical first grade in all hospitals can see the outpatient clinic, but they are all using their own personal account money, when there is no money in the personal account, you need to pay cash; while the basic medical second grade and third grade can be reported every year 1000 yuan, this money is the use of the money of the integrated fund, while the basic medical first class to see the outpatient money is their own money, only the use of the money of the integrated fund is the real meaning of the reimbursement.
The basic medical first class has the following three main advantages, first, continuous enrollment in the basic medical first class for more than 12 months, and in a medical year outpatient out-of-pocket expenses more than 3,131 yuan, more than part of the reimbursement of 70%, second, in all the social hospitals can be reimbursed for outpatient clinics 30%, and third, outpatient clinics to do large-scale equipment examination, you can be reimbursed for 80% of the reimbursement, the The reimbursement is all with the money from the coordinated fund, other than that it is all with the money from your own account.
The main difference between social insurance and commercial insurance:
1, the implementation of different purposes
Social insurance is to provide members of the community with the necessary basic security, not for the purpose of profit; commercial insurance is the commercial operation of the insurance company, for the purpose of profit;
2, the implementation of different ways
Social insurance is mandatory implementation of the national legislation, commercial insurance is followed by the national legislation The implementation of social insurance is based on national legislation, while commercial insurance follows the principle of "freedom of contract" and is voluntarily insured by enterprises and individuals.
Legal basis:
Article 64 of the Social Insurance Law of the People's Republic of China stipulates that the social insurance fund includes the basic pension insurance fund, the basic medical insurance fund, the industrial injury insurance fund, the unemployment insurance fund and the maternity insurance fund. Each social insurance fund maintains separate accounts in accordance with the type of social insurance, and accounts are kept in separate accounts, implementing the State's unified accounting system. Social insurance funds are earmarked for specific purposes, and may not be appropriated or misappropriated by any organization or individual. The basic pension insurance fund to gradually implement the national co-ordination, other social insurance funds to gradually implement the provincial co-ordination, the specific time and steps prescribed by the State Council.