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What does the overall fund payment in medical insurance mean? Can personal payment be reimbursed?

The medical insurance pooling fund refers to the rest of the medical insurance premiums paid by all employers for employees in a co-ordination area after deducting them from personal accounts. Co-ordination fund payment is to use co-ordination account funds to pay the related medical expenses of the insured, account payment, that is, to use your medical insurance card to swipe your card at the pharmacy or clinic. Personal payment cannot be reimbursed.

Extended information:

Differences in payment standards of pooling funds:

① The basic medical expenses incurred by the insured person who goes directly to the town (street) community health service center for emergency treatment outside the service hours of the designated outpatient service point shall be paid by pooling funds according to regulations.

(2) The insured person directly goes to the town (street) community health service center to rescue the basic medical expenses, and the overall fund pays according to the regulations; Directly to the designated outpatient medical point and the town (street) community health service center outside the city's medical institutions outpatient rescue of basic medical expenses, the overall fund payment ratio decreased by 1%.

③ If the patient is referred to the community health service center by the designated outpatient clinic, the overall fund will be paid according to the regulations; Transferred to the town (street) designated hospital headquarters outpatient department or municipal designated specialist hospital headquarters outpatient department, the overall fund payment ratio decreased by 1%; Transfer to the outpatient department of the headquarters of the designated tertiary hospital in the city, and the payment ratio will be reduced by 2%; Transferred to other medical institutions, the overall fund will not be paid.

④ Except for the above situations, the insured person will go to the outpatient clinic of a medical institution other than the designated outpatient clinic, and the overall fund will not pay for it.