The medical insurance pooling account refers to a part of the social medical insurance pooling fund used to pay medical expenses. These funds are paid by all the insured, forming a unified fund to pay the medical expenses of the insured.
The money in the medical insurance pooling account will not be cleared, but will continue to accumulate:
First of all, we must understand the nature of the medical insurance pooling account. This account is cumulative, that is, with the passage of time, the funds in the account will continue to accumulate.
Secondly, it is not in line with the actual situation to clear the money in the medical insurance co-ordination account. Medical insurance is to protect the medical needs of the insured. If the account funds are cleared, then when the insured needs medical expenses, it will not be guaranteed. This not only violates the original intention of medical insurance, but also brings great trouble and inconvenience to the insured.
Finally, we should realize the important role of medical insurance pooling account. By accumulating funds, the medical insurance pooling account can provide financial support when necessary to help the insured bear the medical expenses.
The overall planning fund includes: the remaining part of the total payment of all insured units in the overall planning area after deducting individual accounts; Financial subsidies; Social donation; Bank interest; Late payment fees, etc. The medical insurance pooling fund belongs to the insured, which is stored in a special account and earmarked, and no unit or individual may misappropriate it. The overall fund is mainly used for medical expenses such as hospitalization of insured persons, emergency rescue in non-designated hospitals, referral from different places (hospitals), resettlement in different places, and special disease clinics.
To sum up, the money in the medical insurance pooling account will not be cleared, but will continue to accumulate to ensure the medical needs of the insured.
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.
Social insurance law
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.