1, medical insurance fund payment is medical insurance reimbursement. The insured who has paid the basic medical insurance shall, after the occurrence of the prescribed medical expenses, meet the conditions of medical expenses under the premise of meeting the scope of medical insurance reimbursement, and be paid by the social medical insurance pooling fund. For example, the medical expenses incurred by the insured in the hospital are 5000 yuan, of which 4000 yuan belongs to the insurance scope of medical insurance, so this 4000 yuan will be paid by the medical insurance pooling fund, and the remaining 1 000 yuan is the expenses that users need to pay themselves.

2. The medical insurance fund pays not the money deducted from the medical insurance card, but the money deducted from the overall account. The money in the medical insurance card is part of the individual contribution of employee medical insurance. It can usually be used for outpatient clinics and designated pharmacies, as well as expenses that need to be paid by individuals after completing medical insurance reimbursement.

3. The medical insurance fund refers to the special funds for basic medical insurance for employees raised by medical insurance agencies from units and individuals to ensure basic medical care for employees. The basic medical insurance fund includes two parts: social pooling fund and individual account, which are paid by employers and individual employees according to a certain proportion.

4. Payment of medical insurance benefits refers to that after the employees who participate in the basic medical insurance for employees get sick, the medical insurance agency provides medical services for the sick employees and reimburses their medical expenses according to the conditions and treatment standards stipulated in advance.

Legal basis:

Article 30 of the Social Insurance Law of People's Republic of China (PRC) The following medical expenses are not included in the payment scope of the basic medical insurance fund: (1) Those that should be paid by the industrial injury insurance fund;

(2) It shall be borne by a third party;

(three) shall be borne by public health;

(4) For overseas medical treatment, the medical expenses shall be borne by a third party according to law. If the third party is unable to pay or cannot determine the third party, the basic medical insurance fund will pay in advance. After the basic medical insurance fund pays in advance, it has the right to recover from the third party;