The medical insurance fund is paid by both individuals and the state, so it includes both personal money and state money. Generally speaking, the proportion of medical insurance fund is paid by individuals and employers (or freelancers), and the state will also give appropriate subsidies to the medical insurance fund according to the financial situation. In this way, the medical insurance fund can be used to pay the medical expenses of the insured.

The medical insurance fund is used to pay for medical insurance-related expenses, and the specific use methods are as follows.

1. Medical reimbursement: When the insured enjoys medical services within the scope of medical insurance, he can use the medical insurance fund for reimbursement.

2. Drug procurement: The medical insurance fund can be used to purchase drugs, medical devices and other medical consumables in the medical insurance catalogue.

3. Health management: The medical insurance fund can also be used to promote health information construction, health management services and disease prevention.

How to use the medical insurance fund?

1. Select a designated medical institution: A designated medical institution refers to a hospital or clinic that has signed a contract with the medical insurance department and can directly settle medical expenses.

Insured persons need to choose designated medical institutions as far as possible when seeking medical treatment in order to enjoy medical insurance benefits. If the designated medical institution cannot be selected for special reasons,

Need to advance medical expenses, apply for reimbursement to the medical insurance department within the specified time;

2. Show medical insurance card or certificate: medical insurance card refers to the electronic card used by the insured when enjoying medical insurance benefits, which stores the basic information of the insured and

Personal account funds. Insured persons need to show their personal medical insurance cards or valid identity documents when seeking medical treatment, which is convenient for the identity verification of designated medical institutions.

And information registration;

3. Select eligible medical treatment items and drugs: Eligible medical treatment items and drugs refer to items and drugs that can be included in medical insurance payment after being recognized by the medical insurance department.

Items and medicines within the scope generally have catalogues or lists for reference. When seeking medical treatment, the insured should try to choose medical treatment items and drugs that meet the requirements.

Goods, in order to enjoy medical insurance benefits. If you choose medical treatment items and drugs that do not meet the requirements, you need to bear the expenses yourself;

4. Medical expenses settlement: Medical expenses settlement refers to the part that is determined to be paid by the insured and the medical insurance fund according to the medical insurance policies and standards.

The payment part, and the corresponding apportionment and deduction. After medical treatment, the insured shall go to the settlement window of the designated medical institution in time for settlement and verification.

View personal expense details and personal account balance.

To sum up, the medical insurance fund is jointly funded by individuals, enterprises and the government to pay medical expenses and protect people's health rights and interests. need

It is necessary to strengthen the management of medical insurance funds, promote the reform of medical insurance system, realize universal medical insurance, and improve the efficiency of the use of medical insurance funds.

Legal basis:

People's Republic of China (PRC) social insurance law

second

The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, industrial injury insurance, unemployment insurance and maternity insurance, so as to guarantee citizens' right to get material help from the state and society in accordance with the law when they are old, sick, injured, unemployed and have children.

Article 26

The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.

Article 28

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.