First, the basic concept of Wuhan Overall Fund
Wuhan overall planning fund refers to a fund established in Wuhan medical security system, which is used to pay the medical expenses of the insured. The fund is jointly paid by individuals and units to provide basic medical insurance for the insured.
Second, the factors that affect the use of funds in Wuhan as a whole
Medical insurance policy: Wuhan medical insurance department will formulate specific standards and regulations for the use of overall funds according to local actual conditions and policy requirements. These regulations will affect the use amount of the overall fund, including the reimbursement ratio, the minimum payment standard and the maximum payment limit.
Personal medical insurance account: the balance of the insured's personal medical insurance account, payment, medical records and other factors will also affect the use amount of the overall fund. For example, the insured with a higher balance in the personal medical insurance account may enjoy a higher reimbursement rate when seeking medical treatment.
Levels and types of medical institutions: different levels and types of medical institutions have different charging standards and service quality, so when the insured person goes to different medical institutions for medical treatment, the use amount of the pooling fund will be different.
Three, how to query and use the Wuhan municipal co-ordination fund
The insured can inquire about the use and balance of the overall fund through the official website of Wuhan Medical Security Department and the medical insurance service window. When seeking medical treatment, the insured shall carry a valid medical insurance card and settle medical treatment and expenses according to the medical treatment process of designated medical institutions. Medical expenses that meet the scope of payment by the overall fund shall be paid by the overall fund.
To sum up:
The one-year usage quota of Wuhan Overall Fund is determined according to the relevant policies and regulations of Wuhan and the specific conditions of individual accounts of medical insurance. Insured personnel should understand the local medical insurance policies and personal medical insurance accounts, so as to make better use of the overall fund and reduce the burden of medical expenses. At the same time, the insured should choose designated medical institutions when seeking medical treatment, and settle medical treatment and expenses according to the prescribed procedures to ensure that they enjoy the medical security treatment they deserve.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 28 provides that:
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.