1, conceptual differences
Overall payment is a medical security system that distributes the medical expenses of all insured persons according to a certain proportion. The main sources of funds for overall payment are social insurance funds and financial budget. Medical insurance payment refers to a medical insurance system that the state or local government pays the medical expenses of the insured on the basis of a unified medical insurance system by setting up a medical insurance fund.
2. Differences in scope of application
Overall payment has a wide scope of application, including all social insurance insured persons and some uninsured persons, including urban workers, urban and rural residents, enterprise retirees and so on. Medical insurance payment is mainly for urban workers, urban and rural residents and other on-the-job or retired personnel and their families, not for uninsured personnel.
3. Differences in payment methods
The payment method of overall payment is mainly medical insurance fund, which consists of social insurance fund and financial budget. The medical insurance payment is based on the medical insurance fund and shared by the state and local governments. Therefore, the source of funds for medical insurance payment is mainly composed of government budget and social insurance fund.
4. Differences in payment standards
There are also some differences between the payment standards of overall payment and medical insurance payment. The payment standard of overall payment is mainly the medical insurance fund payment standard formulated by the government, and medical insurance payment is the medical insurance payment standard jointly formulated by the state and local governments. In addition, the payment standard of medical insurance payment also includes specific provisions on the proportion and limit of medical insurance reimbursement.
5. Differences in management methods
There are also some differences between the management methods of overall payment and medical insurance payment. The management mode of overall payment is mainly managed and supervised by the government to ensure the reasonable and fair use of medical insurance funds. The payment of medical insurance is managed and supervised by the state and local governments, and the use of medical insurance funds is strictly examined and supervised.