1. What does medical insurance pooling fund payment mean? The so-called medical insurance pooling fund payment refers to items paid by social security pooling funds, such as medical insurance reimbursement fees, basic pensions in pension insurance, etc., and social security paid by units and individuals.
Part of the fee will go into the social security pooling account, which will be coordinated and used by the social security pooling fund.
The medical expenses incurred by everyone in designated hospitals can be reimbursed, and the reimbursed expenses come from the overall fund. The overall fund is earmarked and cannot be misappropriated by any unit or individual.
The overall pool fund is equivalent to a public fund account. Each type of insurance has its own pool fund account, and different insurance types are managed separately.
2. What is the payment standard of the unified fund? 1. In addition to the treatment at designated outpatient clinics, the expenses incurred by the insured at the local health service center for emergency treatment can be paid according to the unified fund.
2. The insured persons go directly to the local community health service center or health service center for medical treatment. The basic medical expenses incurred during the rescue can be paid according to the overall fund.
3. If the insured person is transferred to the local health service center through the designated outpatient medical treatment point, the payment can also be made according to the overall fund.
In addition to the above situations, if the insured person goes to a place other than the designated medical institution for medical treatment on his own, the medical expense pooling fund will not pay.