Personal account is mainly the basic medical insurance premium paid by individual employees; The basic medical insurance premium paid by the employer who is included in the individual account according to the regulations; Interest on the amount of personal account storage; Other funds incorporated into personal accounts according to law.

The principal and interest of the account are owned by individuals and can only be used for basic medical insurance, but they can be carried forward and inherited according to the actual situation of the insured.

there are two types of accounts in medical insurance, one is the overall fund account, and the other is the personal account. Generally speaking, there are two types of accounts in employee medical insurance, while the resident medical insurance only has the overall fund account and no personal account. As a whole, the fund account is the account that we usually use to settle when we are reimbursed for medical treatment in hospital. The money in it is all from the medical insurance fund pool. If we want to carefully investigate whether it belongs to individuals or not, it should be used by no one. It implements the * * * economic model, that is, whoever needs it will use it, and it will not be used if there is no need. We can't see the money in this account. All we can know from the hospital documents is how far it is from the deductible line and the capping line for reimbursement. However, we don't need to see the money in this account, as long as it is compliant with medical expenses, it can be reimbursed.

medical insurance settlement procedures

(I) settlement procedures for hospitalization and outpatient treatment of special diseases Designated medical institutions shall, before the 1th day of each month, report the expense statement, hospitalization statement and relevant materials of patients discharged from the hospital last month to the medical insurance agency, which will serve as the basis for monthly pre-allocation and year-end final accounts after review. Medical insurance agencies pre-allocate the overall expenses for hospitalization and outpatient treatment of special diseases last month. Insured persons identified as suffering from special diseases should go to a designated medical institution designated by the labor and social security department for medical treatment and purchase medicines, and the medical expenses incurred shall be directly accounted for and settled immediately.

(II) Emergency Settlement Procedure The medical expenses incurred by the insured due to emergency rescue to non-designated medical institutions in the city and medical institutions in different places shall be paid in advance by the individual or unit first. After the emergency rescue is over, the medical insurance agency shall go through the reimbursement procedures according to the regulations with the hospital emergency medical records, inspection, laboratory reports, invoices and detailed medical charges list.

(III) Settlement Procedures for Relocated Workers

1. Relocated workers in different places shall be designated as designated medical institutions by their units

and reported to medical insurance agencies for the record.

2. The medical expenses incurred by the designated medical institution at the place of residence where the off-site workers are ill will be paid in advance by myself or the unit where I work. After the treatment, the unit where I work will go to the social medical insurance agency for settlement on the specified date with the insured's medical certificate and medical records, valid expense bills, compound prescriptions, hospitalization expense list, etc. (4) Referral and referral for settlement

1. The insured will be transferred to other institutions due to the conditions of designated medical institutions or special diseases. The reason for referral and transfer is put forward by the attending physician, the director of the department puts forward the opinion of referral and transfer, the medical institution medical insurance office reviews it, the dean in charge signs it, and it can be transferred only after being reported to the municipal medical insurance center for examination and approval.

2. In principle, the referral should be made first in the city and outside the market, first in the province and then outside the province. The city's referral and transfer regulations are carried out among designated medical institutions. Referral from outside the city shall be proposed by the designated medical institutions above Grade III in this Municipality.

3. The medical expenses incurred by the insured after referral and transfer shall be paid in cash by the individual or unit first. After the medical treatment is over, the insured or his agent shall submit the referral and transfer approval form, medical record certificate, prescription and valid documents to the medical insurance agency for reimbursement of the hospitalization expenses within the scope of the overall fund payment.

Legal basis:

Article 5 of the Guiding Opinions of the General Office of the State Council on Establishing and Improving the Economic Security Mechanism for Employees' Basic Medical Insurance Outpatients

regulates the scope of personal accounts. Personal accounts are mainly used to pay out-of-pocket expenses of insured persons within the policy scope of designated medical institutions or designated retail pharmacies. It can be used to pay the medical expenses incurred by the insured and their spouses, parents and children in designated medical institutions, as well as the expenses incurred by individuals in purchasing drugs, medical devices and medical consumables in designated retail pharmacies. Explore personal accounts for personal contributions for spouses, parents and children to participate in basic medical insurance for urban and rural residents. Personal accounts shall not be used for public health expenses, physical fitness or health care consumption and other expenses that are not covered by the basic medical insurance. Improve the management measures for the use of personal accounts, and do a good job in revenue and expenditure information statistics.