All the money paid for medical insurance is included in the medical insurance pooling fund.
The medical insurance department will enter the medical reimbursement amount into each person's medical insurance card at one time every year according to the individual medical insurance ratio. When each person uses the prescribed standard for medical treatment, the medical insurance center will open another 3 thousand yuan medical insurance pooling fund. After opening, 15% will be paid out of pocket.
, medical insurance 85%, and hospitalization with medical insurance card, medical insurance will be reimbursed with medical insurance pooling funds.
The amount in a personal medical insurance account belongs to the individual. In the absence of consumption, the balance will not be reduced except for the automatic deduction of critical illness insurance in some places.
For urban residents with a registered permanent residence, they participate in the medical insurance for urban residents. The principal part is returned in proportion to the payment grade, and the balance can be carried forward every year.
The basic principle of medical insurance for urban and rural residents is "whole household" insurance, so all families must be insured. It is not allowed for only some members of a family to be insured and some members not to be insured.
To sum up, as the medical insurance network with the largest coverage in the world, the reason why it can continue to operate smoothly lies in the "reservoir" of the medical insurance fund.
The principle of "determining expenditure based on revenue, balancing revenue and expenditure, and leaving a slight surplus" will always ensure that the "reservoir" has a moderate surplus and strive to meet the medical needs of nearly 1.4 billion Chinese people.
Legal basis: Article 10 of the "Social Insurance Law of the People's Republic of China" states that employees shall participate in basic pension insurance, and the employer and employee *** shall jointly pay the basic pension insurance premiums.
Individual industrial and commercial households without employees, part-time employees who have not participated in the basic pension insurance in the employer, and other flexible employment personnel can participate in the basic pension insurance, and the basic pension insurance premiums are paid by individuals.
The measures for pension insurance for civil servants and staff managed with reference to the Civil Servant Law shall be prescribed by the State Council.
Article 11 The basic pension insurance shall be combined with social pooling and personal accounts.
The basic pension insurance fund is composed of employer and individual contributions as well as government subsidies.
Article 12 The employer shall pay basic pension insurance premiums in proportion to the total wages of its employees stipulated by the state and record them into the basic pension insurance overall fund.