the medical insurance card deducts the money from the medical insurance fund, in which the individual pays the self-paid amount and the medical insurance fund pays the reimbursement amount. The medical insurance fund is a social insurance fund paid by individuals and the government, which is used to pay the medical expenses of the insured. When purchasing drugs, pharmacies settle accounts through the medical insurance system, and the system calculates the individual out-of-pocket amount and the reimbursement amount of the medical insurance fund according to the reimbursement ratio and limit. After the individual pays the out-of-pocket amount, the medical insurance fund directly pays the reimbursement amount to the pharmacy.
The relevant regulations on medical insurance card payment for drugs mainly include the following aspects:
First, medical insurance card can be used to buy drugs that meet the scope of medical insurance catalogue, but it is necessary to pay attention to whether it is necessary to pay in advance or whether there are drugs with restricted use. Secondly, when the medical insurance card pays for drugs, it is generally deducted according to a certain proportion, and the specific proportion may vary according to different types of drugs and medical insurance policies. In addition, the medical expenses paid by the medical insurance card will generally be directly deducted from the personal account. If the balance of the personal account is insufficient, it may be necessary to pay in advance or by other means.
to sum up, finally, the specific provisions of medical insurance card for payment of drug expenses may be different due to different regions and medical insurance policies. It is recommended to know the relevant provisions before use to avoid unnecessary troubles.
Legal basis:
Article 23 of the Social Insurance Law of the People's Republic of China
Employees shall participate in the basic medical insurance for employees, and both the employer and the employees shall pay the basic medical insurance premium according to the national regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.
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