in general, we use the funds in our personal account to buy medicines. The personal account of medical insurance is established according to the basic medical insurance, which is specially used to store the medical insurance premiums paid by the insured and the funds allocated by the employer according to a certain proportion. It is a special account for recording medical consumption, and the funds inside can be used.
In our daily life, illness is inevitable, and we often have the need to see a doctor and buy medicine, which will use our medical insurance. However, medical insurance cards are divided into personal accounts and co-ordination accounts. So where do we spend money when we use medical insurance cards to buy medicines?
where does the medical insurance card cost to buy medicine?
in general, we use the funds in our personal account to buy medicines.
(1) Personal account: medical expenses for outpatient and emergency treatment; The cost of purchasing drugs in designated retail pharmacies; Medical expenses below the Qifubiaozhun of the basic medical insurance pooling fund; Medical expenses that exceed the qifubiaozhun of the basic medical insurance pooling fund and should be borne by individuals in proportion.
(2) Overall account: medical expenses for hospitalization; Emergency rescue observation and income hospitalization, the medical expenses within 7 days before hospitalization observation; Outpatient medical expenses of taking anti-rejection drugs after radiotherapy and chemotherapy, renal dialysis and renal transplantation for malignant tumors.
So, the money used by the social security card to buy medicine is the money in the personal account in the medical insurance account. The personal account of medical insurance is established according to the basic medical insurance, which is specially used to store the medical insurance premium paid by the insured and the funds allocated by the employer according to a certain proportion. It is a special account for recording medical consumption, and the funds inside can be used to pay for medical treatment and self-payment for medicine.
as for the funds in our personal account, they are the expenses paid by our employees, and the expenses paid by the unit will be included in the overall account.
However, it should be noted that we can only use the medical insurance card to buy medicines at designated pharmacies, and not all medicines can be reimbursed with the medical insurance card.
There are the following regulations for buying drugs in pharmacies with medical insurance cards: If the drug expenses are within the scope of the basic medical insurance drug list, medical treatment items, etc., the insured can directly settle accounts at the drug business unit; However, the part that exceeds the payment from the basic medical insurance fund shall be borne by the insured.
legal basis
article 26 of the social insurance law of the people's Republic of China
the treatment standards of 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.
article 28
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.
article 29
the part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be directly settled by the social insurance agency, medical institutions and pharmaceutical trading units.
the social insurance administrative department and the health administrative department should establish a settlement system for medical expenses in different places, so as to facilitate the insured to enjoy the basic medical insurance benefits.