Personal payment: all medical insurance premiums paid by individuals enter personal accounts for personal use; Part paid by the unit: the medical insurance premium paid by the unit is divided into two parts, one of which goes into the overall fund and the other into the personal account. The proportion of individual accounts is usually about 30% of the employer's contributions, and the specific proportion varies according to regions and policies. The overall fund is used to pay the medical expenses, serious illness relief, maternity insurance and other expenses of the insured.

The medical insurance unit pays the following fees:

1. The part paid by the company is the overall account, and the individual pays the personal account. The overall account is used for hospitalization, and the personal account can be used for daily drug purchase and outpatient service.

2. Source of funds for the overall fund: The overall fund for basic medical insurance is the basic medical insurance premium paid by the employer, and the remaining funds and interest income after deducting the part transferred to the personal account are the overall fund for basic medical insurance.

3. Use of overall fund: the overall fund is mainly used to pay for outpatient and inpatient medical expenses for special diseases in medical insurance coverage, but it cannot pay for general outpatient expenses and all self-funded items, nor can it pay for medical expenses caused by illegal crimes, alcoholism, suicide, self-mutilation, work injury, maternity, traffic accidents, medical accidents and other liability accidents.

To sum up, only part of the medical insurance expenses paid by individuals and units will enter personal accounts. This part of the funds can be used to pay for outpatient expenses, drug purchases in pharmacies, and medical expenses below the threshold of pooling funds.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 28

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.