1. Treatment fee: refers to the treatment fee, medical treatment fee, injection fee, infusion fee and oxygen delivery fee that meet the requirements of local basic medical insurance coverage during the treatment period.
2. Inspection fee: refers to the inspection, inspection, laboratory test (including reagent fee) and photography fees that meet the requirements of the local basic medical insurance coverage during the treatment period.
3. Operation expenses: refers to the operation expenses that meet the requirements of local basic medical insurance coverage during the treatment period, including operation expenses, anesthesia expenses and material expenses.
4. Drug expenses: refers to the drug expenses incurred in the local basic medical insurance drug list during the treatment period.
5. Nursing expenses: refers to the grade nursing expenses that meet the requirements of local basic medical insurance coverage during the treatment period.
6. Transportation expenses: refers to the cost of ambulance vehicles to save lives and the cost of car use during hospital referral.
7. Lost time: refers to the insured's hospitalization in a medical institution designated or recognized by the insurer due to sudden acute illness or accidental injury, and the insurer pays the lost time according to the standard of medical supplementary insurance amount ×0.5%/ day and the insured's ten-level hospitalization days.
8. Transportation and accommodation expenses for visiting close relatives: refers to the accommodation and transportation expenses incurred by an accompanying relative or a visiting relative of the insured who has been hospitalized for more than three consecutive days (excluding three days) or died. The room and board fee shall not exceed RMB 200 yuan per day, and the means of transportation shall be public transportation.
Personal accident insurance range:
1, death compensation. When the insured suffers accidental injury and causes death, the insurer pays death insurance money.
2. Disability pension. When the insured is disabled due to accidental injury, the insurer pays disability insurance money.
3. medical compensation. When the insured pays medical expenses due to accidental injury, the insurer will pay for it. Accidental injury medical insurance is generally not covered separately, but as an additional insurance for accidental injury, death and disability.
4. Stop payment. When the insured is temporarily unable to work due to accidental injury, the insurer shall pay the shutdown insurance money.
Generally speaking, compensation for accidental injury includes medical expenses, lost time, nursing expenses, transportation expenses, accommodation expenses, food subsidies for hospitalization, necessary nutrition expenses, disability compensation, disability AIDS, etc.
Legal basis:
Regulations on industrial injury insurance
Article 35
Workers who are disabled due to work are identified as one to four levels of disability, retain labor relations, quit their jobs, and enjoy the following benefits:
(1) The industrial injury insurance fund will pay a one-time disability subsidy according to the disability level. The standard is: 27 months' salary for first-degree disability, 25 months' salary for second-degree disability, 23 months' salary for third-degree disability and 2 1 month salary for fourth-degree disability;
(2) Pay the disability allowance from the industrial injury insurance fund on a monthly basis. The standard is: 90% of my salary for first-degree disability, 85% for second-degree disability, 80% for third-degree disability and 75% for fourth-degree disability. If the actual amount of disability allowance is lower than the local minimum wage standard, the industrial injury insurance fund will make up the difference;
(3) After the workers with work-related injuries reach retirement age and go through retirement formalities, they will stop paying disability allowance and enjoy basic old-age insurance benefits in accordance with relevant state regulations. If the basic old-age insurance benefits are lower than the disability allowance, the industrial injury insurance fund will make up the difference.
Workers who are disabled due to work are identified as one to four levels of disability, and the employer and individual employees pay the basic medical insurance premium on the basis of disability allowance.