what is the meaning of medical insurance personal account

medical insurance personal account refers to a special fund account set up by medical insurance institutions for individuals participating in basic medical insurance to record their medical insurance financing and pay their medical expenses.

the full name of medical insurance personal account is called individual medical insurance personal account, which is called personal account for short. Personal accounts are mainly used to record and store personal account funds, and are used for personal medical consumption according to regulations. The main sources of personal account funds include: medical insurance premiums paid by individuals; A certain proportion of social medical insurance premiums paid by the employer; Some include personal account start-up funds paid by employers for individuals; There is also the interest income of personal account funds generated with the increase of insurance years.

personal account payment scope: it is usually used to pay the insured's specific medical expenses, including outpatient expenses incurred by designated medical institutions; Drug purchase expenditure of designated retail pharmacies; In the basic medical expenses for specific items of hospitalization and outpatient service in designated hospitals, the expenses below the Qifubiaozhun of the overall fund shall be paid; Expenses that exceed the minimum threshold and should be borne by individuals. The insured person's use of personal account funds to pay medical expenses shall conform to the provisions of the scope of basic medical drugs, the scope of diagnosis and treatment projects, the scope of medical service facilities and payment standards.

The basic medical insurance for urban workers in China is divided into two accounts according to overall management, namely, overall account and individual account. The individual account here is the medical insurance individual account.

the difference between medical insurance personal account and overall account

1. Personal account is used for:

(1) medical expenses for outpatient and emergency departments;

(2) the cost of purchasing drugs in designated retail pharmacies;

(3) medical expenses below the minimum threshold of the basic medical insurance pooling fund;

(4) medical expenses that exceed the threshold of the basic medical insurance pooling fund and should be borne by individuals in proportion.

Second, the overall account is used for

(1) medical expenses for hospitalization;

(2) The medical expenses of those who are under observation for emergency rescue and are admitted to hospital for treatment within 7 days before hospitalization;

(3) outpatient medical expenses of radiotherapy and chemotherapy for malignant tumor, renal dialysis and taking anti-rejection drugs after renal transplantation.

third, in social security, the unit payment part and the individual payment part are divided, and the unit payment part will enter the overall account, and the individual payment part will enter the individual account. For example, if the pension insurance unit pays 2% of the employee's salary, it will enter the individual account. In medical insurance, a part of the unit payment will be set aside in the employee's personal account (according to local regulations).

The money in the personal account belongs to the individual. In the old-age insurance, when an employee dies before retirement age, the personal account of the old-age insurance will be returned to the beneficiary. The money in the personal account of medical insurance is used by individuals, which can pay the outpatient fee, the part that the individual pays according to the social security medical regulations, and buy medicines, etc. The overall account is owned as * * *.

The latest policy of personal medical insurance account:

Personal medical insurance account can be used by family members!

The executive meeting of the State Council held on April 7th determined the measures to establish and improve the economic security mechanism of basic medical insurance outpatient service for employees, broaden the scope of personal account funds and reduce the medical burden of the masses.

The meeting pointed out that the new round of medical reform in China has established the largest basic medical insurance network in the world, benefiting more than one billion people, which has played an important role in reducing the burden of medical treatment for the masses and alleviating the high cost of medical treatment. In recent years, chronic diseases such as hypertension and diabetes involving many patients have been included in medical insurance reimbursement. The next step is to deepen medical reform, enhance the mutual aid and economic security function of employees' basic medical insurance, and include more outpatient expenses in medical insurance reimbursement to further reduce the burden on patients.