The principal and interest of the account are owned by individuals and can only be used for basic medical insurance, but can be carried forward and inherited according to the actual situation of the insured.
There are two kinds of medical insurance accounts, one is the overall fund account and the other is the individual account. Generally speaking, there are two types of accounts for employees' medical insurance, while residents' medical insurance only has a pool fund account and no personal account. On the whole, the fund account is the account we usually use to settle when we are reimbursed for medical treatment in the hospital. All the money in it belongs to the medical insurance fund pool. If you want to carefully investigate whether it belongs to an individual, it should be useless. It implements the * * * economic model, that is, whoever needs it will use it, and if there is no need, it will not be used. We can't see the money in this account. What we can know from the hospital documents is how far it is from the deductible line and the capping line for reimbursement. However, we don't need to see the money in this account, as long as it meets the medical expenses, it can be reimbursed.
Medical insurance settlement procedure
(I) Settlement Procedures for Inpatient and Outpatient Treatment of Special Diseases Designated medical institutions will report the list of expenses, hospitalization list and related materials of patients discharged from hospital last month to the medical insurance agency before each month/kloc-0, which will be used as the basis for monthly pre-allocation and year-end final accounts after being audited by the medical insurance agency. The medical insurance agency pre-allocated the hospitalization and outpatient expenses for special diseases last month. Insured persons who have been identified as suffering from special diseases shall go to the designated medical institutions designated by the labor and social security departments for medical treatment and medicine purchase, and the medical expenses incurred shall be directly recorded and settled immediately.
(II) Emergency Settlement Procedure The medical expenses incurred by the insured due to emergency rescue to non-designated medical institutions in the city and medical institutions in different places shall be paid in advance by individuals or units. After the emergency rescue, the medical insurance agency shall go through the reimbursement procedures according to the provisions with the hospital emergency medical records, inspection, laboratory reports, invoices and detailed list of medical expenses.
(three) resettlement procedures for resettlement personnel in different places
1. The resettlement of off-site staff shall be designated by the unit where they work.
Designate a medical institution at the place of residence and report it to the medical insurance agency for the record.
2. The medical expenses incurred by the off-site staff in the outpatient department of the designated medical institution where the disease occurs at the place of residence shall be paid in advance by themselves or their units. After the treatment, the unit shall settle the diagnosis and medical records, effective bills, compound prescriptions and hospitalization expenses of the insured in the social medical insurance agency on the specified date (4) referral and transfer settlement.
1. If the insured person is transferred to other medical institutions for diagnosis and treatment due to the conditions of designated medical institutions or specialized diseases, the approval form for referral and transfer shall be filled in. The reason for referral and transfer is put forward by the attending physician, the director of the department puts forward the opinion of referral and transfer, the medical institution medical insurance office reviews it, the dean in charge signs it, and it can be transferred only after being reported to the municipal medical insurance center for examination and approval.
2. In principle, referrals should be made outside the city, inside the province and outside the province. The city's referral regulations are carried out between designated medical institutions. The referral outside the city is proposed by the designated medical institutions above Grade III in this Municipality.
3. The medical expenses incurred after the insured person is referred to another hospital shall be paid by the individual or unit in cash. After the medical treatment, the insured person or his agent will submit the referral approval form, medical record certificate, prescription and valid documents to the medical insurance agency for reimbursement of hospitalization expenses that fall within the scope of the overall fund payment.
Legal basis:
"Guiding Opinions of the General Office of the State Council on Establishing and Improving the Economic Security Mechanism for Outpatients with Basic Medical Insurance for Employees"
Fifth, standardize the use of personal accounts. Personal accounts are mainly used to pay out-of-pocket expenses of insured persons within the policy scope of designated medical institutions or designated retail pharmacies. It can be used to pay the medical expenses incurred by the insured and their spouses, parents and children in designated medical institutions, as well as the expenses incurred by individuals in purchasing drugs, medical devices and medical consumables in designated retail pharmacies. Explore the personal accounts of spouses, parents and children participating in the basic medical insurance for urban and rural residents. Personal accounts shall not be used for public health expenses, physical fitness or health care consumption and other expenses that are not covered by the basic medical insurance. Improve the management measures for the use of personal accounts and do a good job in the statistics of income and expenditure information.