The money in the medical insurance card can be used to pay medical expenses in designated hospitals with medical insurance, or to buy medicines in designated pharmacies.
Taking Zhengzhou as an example, according to Article 25 of the Measures for the Basic Medical Insurance of Workers in Zhengzhou, the overall fund is mainly used to pay the hospitalization expenses, outpatient medical expenses for specified diseases and outpatient medical expenses for serious and serious diseases. Personal account is mainly used to pay for general outpatient medical expenses, drug purchase expenses and hospitalization medical expenses borne by individuals, etc. When the balance of personal account is insufficient to pay, the excess part shall be borne by individuals. The overall fund and individual account shall be accounted for separately, and shall not be misappropriated.
article 41 the medical expenses paid by the insured in the designated medical institutions with personal accounts shall be settled by social security cards. Social insurance agencies shall settle accounts with designated medical institutions according to the actual medical expenses incurred in individual accounts. The medical expenses incurred by the insured in the hospitalization of designated medical institutions shall be borne by the individual and settled by himself and the designated medical institutions; The part that should be paid by the overall fund shall be accounted for.
Social insurance agencies regularly settle medical expenses with designated medical institutions, and reserve a certain percentage of quality deposit. The quality deposit shall be returned according to the annual service quality assessment results.
Extended information:
Article 26 of the Social Insurance Law of the People's Republic of China, the treatment standards of basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 27 Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state, if the accumulated payment reaches the fixed number of years stipulated by the state when they reach the statutory retirement age; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.
article 28 medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards, and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.
Zhengzhou Municipal Government-Measures of Zhengzhou Municipality on Basic Medical Insurance for Employees