The money in the medical insurance card is a personal account, not how much is paid to the bank. Fees paid for employee medical insurance are divided into personal accounts and overall accounts.
Personal accounts can be used for outpatient consumption or self-paid expenses. The collective account is used to reimburse large medical expenses such as hospitalization on a proportional basis according to regulations. Therefore, the medical insurance paid does not protect oneself, but the state protects the individual.
of medical care.
Taking Zhengzhou as an example, according to Article 22 of the "Zhengzhou City Basic Medical Insurance Measures for Employees", the employee medical insurance premiums paid by the employer and the insured individuals constitute the employee medical insurance fund. The employee medical insurance fund is divided into overall funds and individual accounts.
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Article 25 The overall pool fund is mainly used to pay for inpatient medical expenses, outpatient medical expenses for prescribed diseases, and outpatient medical expenses for serious and serious diseases.
The personal account is mainly used to pay for general outpatient medical expenses, drug purchase expenses and inpatient medical expenses borne by the individual. When the balance of the personal account is insufficient for payment, the excess will be borne by the individual.
The overall fund and individual accounts shall be accounted for separately and shall not be misappropriated from each other.
Extended information: Article 29 of the "Zhengzhou Basic Medical Insurance Measures for Employees" provides that for qualified hospitalization medical expenses that exceed the minimum payment standard and do not exceed the maximum payment limit, the overall fund will pay according to the following proportions: (1) If an active employee is hospitalized,
The overall fund payment proportions are: 95% for community health service institutions, 95% for first-class medical institutions, 90% for second-class medical institutions, and 88% for third-class medical institutions; (2) When retirees are hospitalized, the overall fund payment proportions are:
97% of community health service institutions, 97% of first-class medical institutions, 95% of second-class medical institutions, and 93% of third-class medical institutions.
The maximum annual payment limit of the overall planning fund is 150,000 yuan.
After the cumulative payment of the unified fund in a natural year reaches the maximum payment limit, the excess medical expenses will be paid by the employee commercial supplementary medical insurance. The specific measures shall be implemented in accordance with the current regulations.