Medical insurance plan is a kind of welfare system, which aims to ensure that individuals or families can get medical services in the face of illness or injury. The main reasons for reimbursement of medical expenses are as follows:
1. risk diversification: the medical insurance plan enables individuals to cope with high medical expenses by spreading risks to a larger group. When many people share the risk, the premium that everyone needs to pay will be relatively low.
2. Cost control: Medical insurance plans usually negotiate with medical service providers to get lower prices. In addition, there may be various rules and procedures to control unnecessary services and overuse. This will help reduce medical expenses and make the insurance plan more cost-effective.
3. Cash pool: the medical insurance plan collects funds and can pay various medical expenses. When an individual is sick or injured, he can get financial support from the fund. This enables the medical insurance plan to provide a certain degree of economic security and help individuals cope with sudden high medical expenses.
4. Preventive health care: Medical insurance plans usually cover preventive health care services, such as annual physical examination, vaccination and health screening. These services are helpful for early detection and treatment of potential health problems, thus reducing future medical expenses.
5. Drug benefits: Many medical insurance plans also include drug benefits to help individuals get affordable prescription drugs. By negotiating discounts with drug manufacturers or cooperating with drug welfare management companies, medical insurance plans can reduce drug costs and make drugs more affordable.
Medical insurance, that is, medical insurance, has the following advantages:
1, basically do not need to spend money by yourself: in most areas, individuals only need to pay a relatively low monthly rental fee (for example, the relatively high proportion in Beijing is 54.68 yuan), and a certain amount will be credited to their personal accounts every month, which is also a kind of feedback.
2. Medical expenses can be reimbursed: after some outpatient expenses and hospitalization expenses reach a certain deductible line, they can be reimbursed according to the prescribed proportion. In case of accidental injury, serious illness or chronic disease, medical insurance can bear most of the medical expenses and reduce personal economic pressure.
3. Cumulative payment can enjoy higher medical security benefits: generally speaking, male employees pay for 25 years and female employees pay for 20 years. After retirement, they can enjoy exemption and enjoy higher medical security.
4. Convenience of medical insurance transfer: medical insurance transfer provides convenience for individuals to change in different workplaces and ensures the continuity of medical insurance.
5. Low threshold: the threshold of medical insurance is low, regardless of age, and there is no restriction on sickness insurance or insurance methods.
6. Medical insurance is a tool to prevent and resolve the risk of medical expenses: participating in medical insurance is to cope with the risk of diseases that may occur at any time and provide protection.
To sum up, the benefits of medical insurance mainly lie in providing economic security, reducing the medical expenses borne by individuals, and improving the medical insurance benefits after the contributions have accumulated for a certain number of years.
Legal basis:
People's Republic of China (PRC) social insurance law
second
The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to get material help from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.