健康保险(health insurance)

一种预先筹措医疗费用的制度，其透过缴纳保费或税金到一个共同基金中，以支付在保险政策或法律规定内的全部或部分医疗服务费。健康保险中的关键性因素是：预先给付保费或税金，汇集基金，以分摊保费或以就业而不考核其收入或资产为基础的享受保险利益的合格条件。健康保险的范围可能限定某些医疗项目或全部的医疗项目，对那些特定的医疗项目有的可全部偿付其费用，有的是部分给付。健康保险所享有的利益包括被保险人有权享有某些医疗服务或获得某些规定的医疗费用补偿。私人健康保险是由保险公司或其他私人机构来组建或管理；公共健康保险则是由政府经营（参阅social insurance）。上面两种健康保险形式与社会化的医疗、政府的保健计画是十分不同的，在这些计画中，医生是由政府直接或间接雇用，政府也拥有这些医疗设备（如英国的国民保健署）。亦请参阅insurance。

English version：

health insurance

System for the advance financing of medical expenses through contributions or taxes paid into a common fund to pay for all or part of health services specified in an insurance policy or law. The key elements are advance payment of premiums or taxes, pooling of funds, and eligibility for benefits on the basis of contributions or employment without an income or assets test. Health insurance may apply to a limited or comprehensive range of medical services and may provide for full or partial payment of the costs of specific services. Benefits may consist of the right to certain medical services or reimbursement of the insured for specified medical costs. Private health insurance is organized and administered by an insurance company or other private agency; public health insurance is run by the government (see social insurance). Both forms of health insurance are to be distinguished from socialized medicine and government medical-care programs, in which doctors are employed directly or indirectly by the goverment, which also owns the health-care facilities (e.g., Britain's National Health Service). See also insurance.

参考文章

• 健康保险的发展现状保险
• 健康保险的基本分类保险
• 健康保险合同保险人的给付义务范围保险
• 健康保险统计的特征保险
• 健康保险的五类健康险选购指南保险
• 健康保险合同的关系人保险
• 全民健康保险的权利保险
• 健康保险的种类保险
• 健康保险赔款准备金保险
• 健康保险精算的特性保险