Medical fund refers to the funds that are not included in the scope of free medical care, extracted from income according to the standard of free medical care stipulated by the local financial department with reference to the relevant provisions of the free medical care system, and used for free medical care for employees.
Medical insurance is one of the five social security in China. Medical insurance fund refers to the monetary fund raised by enterprises, institutions, organizations or individuals who participate in medical insurance and pay the prescribed amount of medical insurance premiums in the form of law or contract to provide basic medical insurance for the insured. The collection and management of medical insurance funds is mandatory and not for profit.
The tasks of fund financial management are: conscientiously implementing relevant national laws, regulations and policies, and rationally raising and using funds; Establish and improve the financial management system, organize the implementation of fund planning, accounting, analysis and assessment, and truthfully reflect the income and expenditure of the fund; Strictly abide by financial discipline, strengthen supervision and inspection, and ensure the safety of funds.
Medical insurance belongs to the business scope of labor security. The basic medical insurance premiums paid by the insured individuals are all included in the personal account; The basic medical insurance premium paid by the insured unit, except for the part credited to the personal account, is all used as a unified fund, which is managed and used uniformly by the medical insurance agency. Personal accounts are mainly used to pay for outpatient and drug purchase expenses, and the overall fund is mainly used to pay for medical expenses of insured persons for hospitalization, outpatient specific projects and some chronic diseases and family beds.
The serious illness medical assistance fund is used to pay the hospitalization medical expenses above the maximum payment limit of the basic medical insurance pooling fund of the insured.
At present, the financing mode of the basic medical insurance system for urban workers in China is the combination of social pooling and individual accounts, that is, employers and employees pay basic medical insurance premiums according to a certain proportion of total wages, forming social medical pooling funds and individual medical account funds.