Consequences of overall payment by medical insurance card:
1. Insufficient balance of medical insurance card: if the balance of medical insurance card is not enough to pay all medical expenses, other payment methods are needed for settlement, otherwise the hospital may refuse to provide medical services;
2. Increase in the proportion of personal payment: if individuals still have to pay part of medical expenses after the medical insurance card is paid as a whole, the proportion of personal payment may increase, resulting in a heavier burden on individuals;
3. It may be recovered: if the expenses paid by the medical insurance card are inconsistent with the actual situation (such as high medical expenses), it may be recovered by the relevant departments;
4. It may be included in the list of medical insurance arrears: if the balance of medical insurance card is insufficient or there are unresolved medical expenses, it may be included in the list of medical insurance arrears, which will affect personal credit records and reimbursement of medical expenses.
To sum up, before the overall payment of the medical insurance card, we must ensure that the balance of the medical insurance card is sufficient and well kept to avoid loss or misappropriation.
The meaning of overall medical insurance payment is as follows:
1. Overall medical insurance payment is the part of medical insurance premium paid by all employers for employees in the overall planning area, which is included in the overall planning account. It can be mainly used to reimburse the insured's hospitalization medical expenses and special outpatient medical expenses;
2. Generally speaking, the medical insurance pooling fund belongs to all insured persons, which is stored in special accounts and earmarked for special purposes, and no unit or individual may misappropriate it. Corresponding to the overall medical insurance account is the personal medical insurance account. The money in the personal account mainly comes from the part paid by the staff in the medical insurance fee, which can be mainly used to pay for general outpatient service and buy medicine in designated medical institutions.
I hope the above content can help you. Please consult a professional lawyer if you have any other questions.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.