Abbreviation definition: Sickness insurance refers to the insurance with the occurrence of diseases agreed in the insurance contract as the condition for payment of insurance benefits.
Both sickness insurance and medical insurance belong to health insurance, and both are based on the health of the insured. But they are also very different:
First, the coverage is different and the medical insurance coverage is wider.
Sickness insurance, also known as critical illness insurance, is mainly aimed at major diseases that will threaten life or cost a lot. The scope of medical insurance is much wider, from general appendicitis to cancer.
Second: the compensation standard is different.
Sickness insurance is fixed payment. In other words, as long as you suffer from a serious illness stipulated in the contract, the insurance company will immediately pay according to the insured amount. For example, the insured amount is 200,000, and the insurance company compensates 200,000.
Medical insurance is paid according to the actual medical expenses. For example, the insured amount 1 1,000 yuan, the hospitalization expenses are 5,000 yuan, and the insurance company may compensate 4,000 yuan (80% of the actual expenses).
Third: the insurance period is different.
The term of medical insurance is only one year. Insurance, no hospitalization within one year, and the insurance contract is terminated. If you want to continue to be protected, you must pay the renewal fee.
The insurance period of sickness insurance is generally more than 20 years, or even life.
Insurance national conditions
The cash subsidy paid to the insured whose employment is interrupted due to illness is a kind of social insurance. Its function is to make up for the loss caused by the complete or partial loss of labor ability caused by the destruction of physiological functions through social responsibility, so that the basic needs of life can be guaranteed. Sickness insurance 1883 originated in Germany and has been implemented in most countries in the world.
Sickness insurance is legally qualified, requiring qualified doctors to issue certificates about patients' illness and suggestions that they must stop working. According to convention no. 102 the standard of sickness allowance formulated by the international labor organization (ILO) in 1952, together with the income-testing allowance, should reach 45% of the income of a standard worker (the worker himself and his wife and children), and later changed to 60%.
ILO Convention 102 stipulates that the minimum payment period of sickness allowance is 26 weeks; Convention 130 of Convention 1969, namely the Convention on Health Care and Sickness Allowance, was extended to one year. Many developed countries in the world have relaxed the payment period of sickness allowance to 2-3 years, and immediately switched to disability allowance after the payment period expires. The standard is the same as sickness allowance.
China's sickness insurance benefits include sickness allowance and sickness relief. Among them, if an enterprise employee stops working due to illness and has been on sick leave for less than 6 months, he will be paid a sickness allowance equivalent to 60 ~ 100% of his salary according to his continuous service; If the sick leave lasts for more than 6 months, according to the continuous length of service, the sick relief fund equivalent to 40 ~ 60% of my salary will be paid. Employees of state organs and institutions whose sick leave is within 2 months shall be paid the original salary; If the sick leave exceeds 2 months, from the third month, if the length of service is less than 10 years, pay 90% of my salary; if it exceeds 10 years, pay the original salary; If the sick leave lasts for more than six months, starting from the seventh month, 70% of my salary will be paid to those with less seniority 10 and 80% to those with seniority 10.