Social security payment business covers more than 300 cities, with self-service payment via mobile phone, error-free operation of the intelligent insurance system, real-time tracking of processing progress, and peace of mind. Many friends will find that when using medical insurance for reimbursement, their personal medical insurance accounts clearly have balances, but they need

Self-pay? Why is this? In fact, when paying for medical insurance, there are two types: cash and accounting. The specific situation and Xiaodou will look at it! The medical consumption details we found on the system are mainly divided into two forms:

Cash payment fees and medical insurance billing fees.

Expenses that require cash payment are mainly because the expenses are self-pay or out-of-pocket portions, while medical insurance accounting expenses are mainly paid through personal accounts and overall funds.

Take Shenzhen Medical Insurance as an example: Personal accounts are only available in the first tier of medical insurance. Although the money in the personal account is deposited into the personal social security card, you cannot withdraw cash if you want! If the insured person has any minor ailments, go to

When the hospital visits an outpatient clinic and prescribes medicine, the money deducted from the personal medical insurance account is deducted.

Most of the remaining money from medical premiums is transferred to the basic medical insurance co-ordination fund. The money from the basic medical insurance co-ordination fund is used to reimburse everyone for medical expenses. For example, the second and third-tier insured people go to the social health outpatient clinic to prescribe medicine.

After paying the fee and swiping the social security card, the amount that needs to be paid is the remaining fee after deducting the proportional reimbursement from the unified fund.

The basic medical insurance co-ordination fund mainly protects the insured's large medical expenses, such as hospitalization.

And some friends may feel strange: Why do I still have money in my personal account, but I still need to pay cash when I go to the doctor? The medical insurance card has enough money, why do I need to pay in cash? 1. Some insured people pay for themselves when they go to the hospital.

, you may incur expenses that are not covered by the medical insurance catalog, that is, out-of-pocket expenses.

For example, medical insurance cannot reimburse diagnostic and treatment items, medicines, and medical consumables. These expenses cannot be reimbursed using the medical insurance pooling fund, nor can they be paid using medical insurance personal accounts.

2. In addition to the out-of-pocket expenses, the insured person undergoes special outpatient examinations (such as CT, MRI, etc.) through medical insurance. Some of the expenses have been reimbursed according to the prescribed proportion through the overall fund (displayed as "accounting"

), the remaining expenses are self-payment.

What methods of "accounting" are included in the details of medical expenses? 1. Medical insurance personal account According to the "Shenzhen Social Medical Insurance Measures", the personal account of the first-tier basic medical insurance insured is used to pay the insured's basic outpatient medical expenses and local supplements.

Medical expenses and the cost of purchasing drugs within the scope of the medical insurance catalog at designated retail pharmacies with prescriptions issued by doctors at designated medical institutions in this city.

When an insured person seeks medical treatment in an outpatient clinic, if the personal account of the medical insurance is involved, the system's medical consumption details will be displayed as "accounting".

2. When the first-tier insured persons of the medical insurance pooling fund seek medical treatment in outpatient clinics, there are also situations where the medical insurance pooling fund will reimburse them in accordance with regulations, such as special outpatient examinations (the pooling fund reimburses 80%), and outpatient prescriptions for specific diseases (divided into three categories of benefits)

, general outpatient blood transfusion (90% reimbursed by the overall fund), etc.

If the insured person enjoys outpatient treatment, which involves payment from the medical insurance co-ordination fund, the system's medical consumption details will also be displayed as "accounting".

I would also like to remind everyone that the second and third levels of medical insurance do not have personal accounts.