1. Personal account: transfer part of the medical insurance premium paid by employees to personal account every month to pay for outpatient service and drug purchase. If the funds in the personal account are used up, the balance is zero.
2. Social pooling: another part of the medical insurance fund will enter the social pooling account to pay for hospitalization expenses and special diseases. The use of this part of the funds needs to be carried out in accordance with certain regulations and procedures, and employees cannot control it at will.
3. Scope of medical insurance payment: the medical insurance fund can only pay the medical expenses that meet the requirements, and the expenses beyond the scope of medical insurance payment need to be borne by employees. This may also result in the employee's actual available medical insurance balance being zero.
Benefits for employees to pay medical insurance:
1. Protecting employees' health: Medical insurance provides basic medical insurance for employees. When employees are sick or injured, they can reimburse some medical expenses through medical insurance to reduce the economic burden. This helps employees to seek medical treatment in time and maintain their own health.
2. Improve the quality of life: Medical insurance can reduce the economic pressure of employees due to diseases, so that employees can cope with diseases more calmly, thus improving the quality of life. At the same time, medical insurance can also provide certain psychological comfort for employees and enhance their confidence in the future.
3. Promote social harmony: The implementation of the medical insurance system will help to narrow the gap between the rich and the poor and reduce poverty caused by illness. Through the popularization and promotion of medical insurance, more people can enjoy medical insurance, promote social fairness and justice, and achieve prosperity.
To sum up, the reasons why employees pay medical insurance but the balance is zero may be the use of personal account funds, the failure to use social pooling funds according to regulations and procedures, and the limitation of medical insurance payment scope. Workers should understand the use and distribution of medical insurance funds, make reasonable plans for medical treatment and medication, and make full use of medical insurance resources.
Legal basis:
People's Republic of China (PRC) social insurance law
Article 60
The social insurance fund shall, in accordance with the investment and operation principles stipulated by the state, implement the principle of balance of payments and slight balance. This means that the medical insurance fund needs to achieve a slight balance on the premise of ensuring balance of payments. Therefore, employees' personal account funds and social pooling funds need to be used and distributed in accordance with relevant regulations and procedures.