The medical insurance fund consists of medical insurance premiums paid by the insured and government subsidies, which are used to provide medical security for the insured. The medical insurance fund covers a wide range, including hospitalization expenses, outpatient expenses, medicine expenses and so on.
In employee medical insurance, the way and proportion of fund payment vary with regions and medical insurance policies. Generally speaking, the higher the proportion paid by the medical insurance fund, the lower the proportion that the insured needs to bear. However, the proportion of medical insurance fund payment is also limited by the affordability of medical insurance fund, which needs to be set reasonably according to the actual situation. It should be noted that the medical insurance fund payment does not fully bear the medical expenses. In addition to the medical insurance fund payment, the insured person also needs to bear a certain proportion of personal self-payment and self-payment Therefore, when using the medical insurance fund to pay medical expenses, it is necessary to know the specific payment ratio and limit.
To sum up, fund payment in employee medical insurance is a way to pay medical expenses, and the medical insurance fund bears part or all of the medical expenses. The specific proportion and limit vary from region to region and policy, which requires the insured to understand and use reasonably.
Legal basis:
People's Republic of China (PRC) 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.