Legal analysis: the medical insurance pooling fund refers to the rest of the medical insurance premiums paid by all employers for employees in a co-ordination area, after deducting them from personal accounts. The medical insurance pooling fund belongs to all the insured persons, and is managed by the social insurance agency in a centralized way and used in a unified way. It is mainly used to pay the medical expenses, operation expenses, nursing expenses and basic inspection fees of the insured workers. The medical insurance fund shall be specially stored and earmarked, and no unit or individual may misappropriate it. The overall planning fund includes: the remaining part of the total payment of all insured units in the overall planning area after deducting the personal account; Financial subsidies; Social donation; Bank interest; Late payment fees, etc. The medical insurance pooling fund belongs to all the insured persons, and it is specially stored and earmarked, and no unit or individual may misappropriate it. The overall fund is mainly used for medical expenses such as hospitalization of insured persons, emergency rescue in non-designated hospitals, referral in different places (hospitals), resettlement in different places, and special disease clinics.
Legal basis: Article 28 of the Social Insurance Law of the People's Republic of China
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations.
article 29 the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, medical institutions and pharmaceutical trading 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.