The overall payment of medical insurance can be directly reimbursed, or it can be reimbursed by the social insurance agency after the insured pays the medical expenses. The medical expenses incurred by the insured in the agreed medical institutions that meet the basic medical insurance drug list, diagnosis and treatment items and medical service facilities standards shall be paid from the basic medical insurance fund in accordance with state regulations.
Is it your own money paid from the medical insurance pooling fund?
The medical insurance fund consists of overall funds and individual accounts. The pooling fund is mainly used to pay medical expenses within the basic medical scope, hospitalization medical expenses higher than the Qifubiaozhun of the pooling fund and lower than the maximum payment limit, specific outpatient items and fixed medical subsidies for chronic outpatients; The personal account is mainly used to pay the general outpatient expenses that meet the basic medical insurance regulations, and the expenses for purchasing drugs in retail pharmacies and specific items for employees' hospitalization and outpatient chronic diseases are borne by individuals.
I hope the above content can help you. Please consult a professional lawyer if you have any other questions.
Legal basis: Article 28 of the Social Insurance Law.
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.