1. Different purposes: medical insurance payment is mainly used to pay for hospitalization expenses, and personal account payment is used to pay for outpatient and emergency expenses.
2. Reimbursement scope and limit: the utilization rate of medical insurance co-ordination payment in social security reimbursement is high, so there are usually more restrictions on the amount and scope of reimbursement.
3. Outpatient co-ordination: Outpatient co-ordination is a form of medical insurance benefits, that is, the general outpatient expenses of the insured are included in the scope of reimbursement, and the general outpatient expenses are borne by the basic medical insurance co-ordination fund and individuals.
The role of medical insurance:
1. is conducive to improving labor productivity and promoting production development.
2. Adjust income differences and reflect social equity.
3. An important guarantee for maintaining social stability.
4. An important means to promote social civilization and progress.
5. An important guarantee for promoting economic system reform, especially the reform of state-owned enterprises.
To sum up: outpatient co-ordination means that the outpatient expenses of the insured are included in the scope of reimbursement of the co-ordination fund in the basic medical insurance. Generally speaking, the outpatient service is not reimbursed, but you can go to the hospital where you often go to see a doctor for "outpatient co-ordination and fixed point", so that you can enjoy preferential treatment when you see the outpatient service there.
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.