The medical insurance fund pays not only with its own money. The medical insurance fund includes two parts: social pooling fund and individual account, which are paid by employers and individual employees according to a certain proportion. Among them, the personal account payment of medical insurance is based on "part of the medical insurance premium paid by the unit+the medical insurance premium paid by the individual employee", while the medical insurance social pooling fund belongs to all insured persons and is only managed by the social security agency and used uniformly. Therefore, the medical insurance fund payment is not only paid with the insured's own money.

Characteristics of fund payment

1, fund payment can only be used for medical expenses within the scope of medical insurance payment, and cannot be used for drugs and projects outside the scope of medical insurance payment;

2, fund payment can only be carried out in designated medical institutions, not in non-designated medical institutions;

3. The fund payment requires the insured to use the medical insurance card or other valid documents for identity verification, and cannot use other people's documents or no documents;

4. Fund payment shall conform to local medical insurance policies, including deductible line, capping line and reimbursement ratio.

To sum up, strictly speaking, the medical insurance pooling fund payment is not its own money, but belongs to all the insured, but is managed and used by the social insurance agency.

Legal basis:

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.

Article 29

The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.

The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.