The difference between medical insurance accounts over the years and this year's accounts lies in the different funds.
The money in the accounts over the years is the expenses paid before this year plus the part paid by the company and included in the personal account, then the money spent before seeing a doctor and the amount pre-paid in this year are deducted, and finally the interest income is added; The insured person has not actually paid the money in this year's account, but the medical insurance amount calculated according to the payment base of the previous year is included in the personal account. Finally, it is necessary to liquidate the money prepaid in the previous year, and refund more and make up less.
medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the payment of employers and individuals. After the insured person suffers from medical expenses, the medical insurance institution will give him some economic compensation.
Legal Basis
Social Insurance Law of the People's Republic of China
Article 2 The state establishes social insurance systems such as basic old-age insurance, basic medical insurance, work injury insurance, unemployment insurance and maternity insurance to protect citizens' rights to receive material assistance from the state and society in case of old age, illness, work injury, unemployment and maternity. Twenty-third employees should participate in the basic medical insurance for employees, and the employer and employees should pay the basic medical insurance premiums in accordance with the provisions of the state.
individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employing unit and other flexible employees can participate in the basic medical insurance for employees, and individuals will pay the basic medical insurance premium according to state regulations. Twenty-sixth basic medical insurance for employees, new rural cooperative medical care and basic medical insurance for urban residents shall be implemented in accordance with state regulations. Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue shall be paid from the basic medical insurance fund in accordance with state regulations. Thirtieth the following medical expenses are not included in the scope of payment of the basic medical insurance fund:
(a) should be paid from the industrial injury insurance fund;
(2) It shall be borne by a third party;
(3) It shall be borne by public health;
(4) seeking medical treatment abroad.
the medical expenses shall be borne by the third party according to law. if the third party fails to pay or cannot determine the third party, the basic medical insurance fund shall pay in advance. After the basic medical insurance fund has paid in advance, it has the right to recover from the third party.