(1) outpatient and emergency medical expenses;

(2) the cost of purchasing drugs in designated retail pharmacies;

(3) the basic medical insurance fund Qifubiaozhun below the medical expenses;

(4) medical expenses that exceed the qifubiaozhun of the basic medical insurance pooling fund and should be borne by individuals in proportion.

Second, the overall proportion:

(1) hospitalization expenses;

(2) medical expenses within 7 days before emergency observation and hospitalization;

(3) Outpatient medical expenses of chemotherapy and radiotherapy for malignant tumor after renal transplantation, renal dialysis and taking anti-rejection drugs.

Three, in social security, the unit payment part and the individual payment part are separated. The unit payment enters the overall account, and the individual payment enters the personal account. For example, the pension insurance unit pays 20% of the employee's salary and enters the personal account. In medical insurance, part of the company's contribution will be left in the employee's personal account (according to local regulations).

The money in the personal account belongs to the individual. In the old-age insurance, if an employee dies before retirement age, the personal account of the old-age insurance will be returned to the beneficiary. The money in the personal account of medical insurance is for personal use, which can pay the outpatient expenses, the part paid by the individual according to the social security medical regulations, and buy medicines. The total account is * * *.

Extended data:

The international equivalent English term is "pooling", which is the concept of fund risk pool. Therefore, the overall level of social insurance can be understood not only from the administrative level, but also from the adjustment range of the coverage population.

Personal account: corresponding to social pooling. The personal account mode is to put all the collected pension insurance premiums into the personal account. When workers enter old age, lose their ability to work and leave the labor market, they will receive their own pension according to the accumulated amount (principal+operating income) in the personal account.

This model has a certain incentive effect on workers, but it does not reflect the "law of large numbers", has no function of mutual assistance and risk sharing, and has great pressure on capital preservation and appreciation. In specific institutional arrangements, this model is always associated with the completely accumulated financial model.