You can use it whenever you need it. The money in the medical insurance pooling account is used by the insured in the event of reimbursement for major diseases. Reimbursement needs to be treated in a designated medical insurance hospital, and treatment expenses can be reimbursed if certain conditions are met. When the type of outpatient service exceeds 2,000 yuan and the medical expenses such as diseases prescribed by medical insurance are reimbursed, the funds in the overall account can be used. The basic medical insurance system in China adopts the mode of combining social pooling with individual accounts. The basic medical insurance fund shall, in principle, implement municipal co-ordination.

What's the difference between a medical insurance pooling account and a medical insurance personal account?

1. Everyone is different: the owner of the medical insurance pooling fund is all the insured, and the owner of the personal account is the insured himself;

2. The composition of funds is different: pooling funds to achieve fund benefits comes from the medical insurance fees paid by various units to employees; Personal account funds mainly come from the expenses paid by the insured and part of the expenses paid by the unit;

3. The scope of reimbursement is different: medical insurance pays large expenses such as reimbursement of hospitalization expenses, special outpatient expenses, partial chemotherapy and dialysis treatment expenses; Personal account is used to buy medicine, outpatient expenses, and the part that needs to be borne by individuals after overall payment. The personal account balance of medical insurance refers to the amount stored in the personal account of urban workers, but there is no personal account balance in the medical insurance of urban and rural residents.

To sum up, the money in the medical insurance pooling account is used by the insured in the reimbursement of major diseases. Reimbursement needs to be treated in a designated medical insurance hospital, and only when certain conditions are met can the treatment expenses be reimbursed. When the type of outpatient service exceeds 2,000 yuan and the medical expenses such as diseases prescribed by medical insurance are reimbursed, the funds in the overall account can be used. Medical insurance includes pooling accounts and personal accounts, in which personal accounts are used to buy medicines and pooling accounts are used for hospitalization reimbursement.

Legal basis:

Article 28 of People's Republic of China (PRC) Social Insurance Law

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.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units. The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.