Fund payment usually refers to the overall fund payment, and the overall fund refers to the payment of medical insurance contributions of all units in a public fund, which is not credited to the personal account. Overall fund payment refers to the use of funds in the overall account to pay the relevant medical expenses of the insured. The use of overall fund payment shall conform to local medical insurance policies, including hospitals and medical institutions, reimbursement scope, deductible line and proportion.

Is medical insurance fund payment reimbursement?

In fact, medical insurance fund payment is reimbursement. Fund payment refers to the use of medical insurance funds to pay the insured's medical expenses, and individuals do not need to pay or reimburse.

According to the provisions of Article 28 of the Social Insurance Law, it is one of the five types of social security in China, which conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and medical expenses for emergency rescue, and the medical insurance expenses are paid by the basic medical insurance fund according to state regulations. Medical insurance fund refers to the act of collecting medical insurance premiums from enterprises, institutions, organizations or individuals participating in medical insurance in the form of law or contract, and providing basic medical care for the insured.

According to the basic requirements for the payment of basic medical insurance benefits in China, the insured person must meet the following conditions to reimburse the medical expenses incurred by medical insurance institutions:

(1) The insured must go to the designated medical institution of basic medical insurance or to the designated retail pharmacy determined by the social insurance institution with the medical prescription issued by the doctor in the designated hospital.

(2) The medical expenses incurred by the insured in the process of medical treatment must conform to the basic medical insurance drug list, diagnosis and treatment items, the standard scope of medical service facilities and payment standards, and be paid by the basic medical insurance fund according to regulations.

(III) Among the medical expenses that the insured meets the scope of payment of basic medical insurance, the part that is higher than the Qifubiaozhun of the social medical co-ordination fund and lower than the maximum payment limit shall be paid by the social medical co-ordination fund in a unified proportion.

Need to be reminded: medical insurance payment is not using the money paid by yourself, and it can no longer be reimbursed.