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What does medical insurance account balance mean?

The meaning of the medical insurance account balance is as follows: The balance of the medical insurance personal account refers to the amount of savings of the insured in the urban employee medical insurance. This part of the funds mainly comes from the contributions of individuals and their units.

The funds in the personal account can be used to pay for minor illnesses, outpatient expenses, etc., while the part paid by the unit is divided into two parts, one part goes into the personal account, and the other part is used to establish the overall fund.

The overall account is managed by the medical insurance center and is used to reimburse the medical expenses of insured persons, such as the personal out-of-pocket portion of hospitalization expenses.

The payment period for basic medical insurance for employees is 25 years for men and 20 years for women. After reaching this period, retirees can enjoy basic medical insurance benefits and no longer pay insurance premiums.

The balance of the personal medical insurance account can be checked through the medical insurance card to ensure that the fees paid by the unit have been paid in place.

The functions of the medical insurance account: 1. Used to pay part of the medical expenses: the medical insurance account is usually used to pay the medical expenses of the insured within the specified range; 2. Personal account fund management: the funds in the medical insurance account are paid by individuals and

The medical insurance fees paid by the unit are used for personal medical consumption; 3. Reduce personal burden: Part of the fees paid through the medical insurance account can reduce the cash payment pressure of the insured; 4. Promote the consumption of medical services: the existence of the medical insurance account

Encourage insured persons to seek medical treatment promptly when sick and promote reasonable consumption of medical services; 5. Guarantee basic medical needs: Medical insurance accounts are part of the medical security system to ensure that the basic medical needs of insured persons are met.

To sum up, the balance of the personal medical insurance account is the savings of urban employee medical insurance participants, which is composed of individual and unit contributions and is used to pay for outpatient and other expenses. At the same time, part of the funds paid by the unit is used to establish a coordinating fund to cover hospitalization and other expenses.

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After employees reach the specified payment period, they can enjoy retirement medical insurance benefits, and the balance can be checked through the medical insurance card to supervise the implementation of the unit's payment.

Legal basis: Article 4 of the "Guiding Opinions of the General Office of the State Council on Establishing and Improving the Financial Security Mechanism for Outpatient Basic Medical Insurance for Employees" improves the personal account accounting method.

Scientifically and rationally determine the method and level of crediting personal accounts. The personal accounts of active employees are credited to the basic medical insurance premiums paid by individuals. The crediting standards are in principle controlled at 2% of the individual’s insured payment base. The basic medical insurance premiums paid by the unit are

All pension fees will be included in the overall fund; in principle, the personal accounts of retirees will be transferred from the overall fund according to a fixed amount, and the transfer amount will be gradually adjusted to about 2% of the average level of basic pensions in the year when the overall planning region implements the reform in accordance with these opinions.

The specific proportion or standard for personal account transfers will be determined by the provincial medical insurance department in conjunction with the financial department in accordance with the above principles, guiding the coordinating region and taking into account local actual research.

After adjusting the overall pooling fund and individual account structures, the increased pooling fund is mainly used for outpatient financial security and to improve the outpatient benefits of insured persons.