Current location - Trademark Inquiry Complete Network - Tian Tian Fund - Who benefits from the lack of money in the personal account of medical insurance?
Who benefits from the lack of money in the personal account of medical insurance?

Generally, it is paid to the beneficiary or legal heir designated by the deceased before his death. According to the Decision of the State Council on Establishing a Unified Basic Old-age Insurance System for Enterprise Employees, if an employee or retiree dies, the individual contributions in the personal account can be inherited. In the Notice on Printing and Distributing the Interim Measures for the Management of Individual Accounts of Employees' Basic Endowment Insurance issued by the Ministry of Labor, it is stipulated that when a retiree dies, the balance of individual contributions in his personal account will be paid to the beneficiary or legal heir designated by the deceased before his death.

The reasons why the money in the personal account of medical insurance is less every month are as follows:

1. The inquiry method is wrong. Medical insurance cards are divided into medical insurance personal accounts and medical insurance financial accounts. If you don't deposit money in the financial accounts, go to the ATM of the bank to check, and there will be no money in the medical insurance cards. If you want to inquire about the personal account of medical insurance, you need to go to the designated hospitals, pharmacies and medical insurance agencies, or you can call the 12333 social security hotline to inquire;

2. The medical insurance institution has not yet transferred the account. If you haven't got the medical insurance card for a long time, it will show zero when checking the balance. It may be that the medical insurance agency has not officially transferred the account, so just wait patiently;

3. Participating in urban and rural residents' medical insurance Now the basic medical insurance for urban and rural residents (including the new rural cooperative medical insurance and urban residents' medical insurance) is gradually canceling the personal medical insurance account and transitioning to the outpatient co-ordination account. Therefore, the insured who participates in the medical insurance for urban and rural residents no longer has a personal account for medical insurance, so the balance will be zero yuan if you check it. If there is money in it before, it can be used as the insurance fee for next year.

Personal medical insurance account refers to a special fund account set up by medical insurance institutions for individuals participating in basic medical insurance to record their medical insurance financing and pay their medical expenses. Personal account of medical insurance is called basic medical insurance personal account for short. Personal accounts are mainly used to record and store personal account funds, and are used for personal medical consumption according to regulations. The main sources of personal account funds include: medical insurance premiums paid by individuals; A certain proportion of social medical insurance premiums paid by the employer; Some include personal account start-up funds paid by employers for individuals; There is also the interest income of personal account funds generated with the increase of insurance years. Personal account payment scope: usually used to pay the insured's specific medical expenses, including outpatient expenses incurred by designated medical institutions; Drug purchase expenditure of designated retail pharmacies; In the basic medical expenses for specific items of hospitalization and outpatient service in designated hospitals, the expenses below the Qifubiaozhun of the overall fund shall be paid; Expenses that exceed the minimum threshold and should be borne by individuals. The insured person's use of personal account funds to pay medical expenses shall conform to the provisions of the scope of basic medical drugs, the scope of diagnosis and treatment projects, the scope of medical service facilities and payment standards. According to the overall management, the basic medical insurance for urban workers in China is divided into two accounts, namely, the overall account and the individual account. The individual account here is the medical insurance personal account.

The decrease in personal medical insurance account is mainly due to the change of outpatient security mechanism after the implementation of outpatient economic security. For employee medical insurance, all the unit contributions are included in the medical insurance pooling fund, and some of them are no longer included in personal accounts; For retirees, it is to directly reduce the criteria for the inclusion of medical insurance personal accounts, and the reduced money is also directly included in the medical insurance pooling fund account. This move is mainly to improve the level of outpatient support for employees as a whole. Ordinary outpatient clinics can also be reimbursed like hospitalization, and the reimbursement rate is as high as 5%. The specific reimbursement ratio is different according to different regions.

Legal basis:

Article 1 of the Social Insurance Law of the People's Republic of China stipulates that employees shall participate in the basic old-age insurance, and the employer and employees shall pay the basic old-age insurance premium. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic old-age insurance in the employer and other flexible employees can participate in the basic old-age insurance, and individuals pay the basic old-age insurance premium. The measures for endowment insurance for civil servants and staff managed with reference to the Civil Service Law shall be formulated by the State Council.