Current location - Trademark Inquiry Complete Network - Tian Tian Fund - Understanding: the difference between medical insurance pooling fund and individual account
Understanding: the difference between medical insurance pooling fund and individual account

the difference between medical insurance pooling fund and individual account is mainly reflected in the following aspects: basic medical insurance is a part of China's basic social security, and general basic medical insurance can be divided into two types, namely, basic medical insurance for employees and basic medical insurance for urban residents. It is worth mentioning that only employee medical insurance has both medical insurance pooling fund and personal account, and the expenses paid by urban residents' medical insurance are directly entered into the medical insurance pooling fund account. So what's the difference between the medical insurance pooling fund account and the individual account? Let's get to know each other. The difference between medical insurance pooling fund and individual account 1. The sources of funds of accounts are different: the funds of medical insurance pooling fund account come from the medical insurance expenses paid by enterprises and the medical insurance expenses of urban residents; The fund of medical insurance personal account comes from the amount paid by individual employees in employee medical insurance. 2 Different functions: the medical insurance pooling fund is used for reimbursement of medical treatment in designated medical insurance hospitals, and can only be used for reimbursement of hospitalization, but it cannot be used for reimbursement of drugs purchased in pharmacies; The funds in the personal account can be mainly used for purchasing medicines in designated pharmacies of medical insurance and medical expenses that need to be paid by individuals outside the medical insurance pooling fund can be paid by the user's personal account of medical insurance. 3 Different reimbursement ratio: the reimbursement of medical insurance pooling fund is proportional, which will be different according to the level of medical hospitals, and the reimbursement ratio of urban residents' medical insurance and employees' medical insurance is also different. Urban residents' medical insurance has a deductible line; The funds in the personal account of medical insurance can be used at will as long as they are purchased at medical insurance pharmacies and treated in outpatient clinics, and there is no restriction on the use threshold.