1, the medical insurance pooling fund refers to the medical insurance premiums paid by all employers for employees in a pooling area, excluding the rest after being included in personal accounts;

2, the medical insurance fund belongs to all the insured, centralized management by social insurance institutions, unified adjustment, mainly used to pay medical expenses, surgery fees, nursing fees, basic inspection fees, etc. ;

3, the medical insurance fund to implement special storage, earmarking, no unit or individual may misappropriate.

The function of medical insurance is:

1 is conducive to improving labor productivity and promoting the development of production;

Medical insurance is the inevitable result of social progress and production development. Conversely, the establishment and improvement of medical insurance system will further promote social progress and production development. On the one hand, medical insurance relieves the worries of workers, makes them work with peace of mind, can improve labor productivity and promote the development of production; On the other hand, it also ensures the physical and mental health of workers and the normal reproduction of labor;

2. Adjust the income gap and reflect social equity;

Medical insurance is an important means for the government to redistribute income by collecting medical insurance premiums and paying medical insurance service fees.

3. An important guarantee for maintaining social stability;

Medical insurance helps sick workers economically, helps to eliminate social instability caused by diseases, and is an important social mechanism to adjust social relations and social contradictions;

4. An important means to promote social civilization and progress;

The social system of medical insurance and social mutual assistance embodies a new social relationship of "one party is in trouble and all parties support" by the insured sharing the risk of disease costs, which is conducive to promoting social civilization and progress;

5. An important guarantee for promoting economic system reform, especially the reform of state-owned enterprises.

Legal basis: Article 30 of the Social Insurance Law of People's Republic of China (PRC).

The following medical expenses are not included in the payment scope of the basic medical insurance fund:

(a) shall be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) Go abroad for medical treatment.

Medical expenses that should be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party.