1. The basic concept of medical insurance pooling account.
The medical insurance pooling account is an important part of China's medical insurance system, and it is a large pool formed by the joint payment of all employees participating in medical insurance. The purpose of this pool is to ensure that all insured persons have adequate financial support when they need medical care. The funds in the medical insurance pooling account are mainly used to pay for the medical expenses of the insured, including but not limited to hospitalization expenses, outpatient expenses, drug expenses, etc.
2. The scope of use of the medical insurance pooling account.
Hospitalization expenses: When the insured person needs to be hospitalized due to illness or accident**, the medical insurance pooling account will pay part or all of the ** expenses, and the specific payment ratio varies according to the region and medical insurance policy.
Outpatient expenses: In some areas, the medical insurance pooling account can also be used to pay for outpatient medical expenses, such as ** fee, examination fee, ** fee, etc.
Drug costs: The medical insurance pooling account covers a part of the drug costs, but it is usually limited to the drugs in the medical insurance list.
Special** and high-value consumables: For some expensive special** and high-value consumables, the medical insurance pooling account will also provide certain support.
3. How to use the medical insurance pooling account.
Medical treatment with a card: Insured persons need to go to designated medical institutions with their medical insurance cards for medical treatment, and they can enjoy medical insurance benefits by showing their medical insurance cards at the time of settlement.
Fee settlement: After providing medical services, medical institutions will settle fees with medical insurance institutions. The insured only needs to pay the part that should be borne by the individual, and the rest is paid by the medical insurance pooling account.
Non-local medical treatment: For insured persons who seek medical treatment in other places, they need to go through the filing procedures for remote medical treatment first, and then seek medical treatment in designated medical institutions in other places with the card, and the fee settlement method is the same as that in the local area.
Fourth, precautions and popular science knowledge.
Understand the policy: There are differences in medical insurance policies in different places, and insured persons should understand the specific policies in their own area, including the reimbursement ratio and reimbursement scope.
Designated institutions: Insured persons should choose medical insurance designated medical institutions for medical treatment, otherwise they may not be able to enjoy medical insurance benefits.
Personal burden: Despite the support of the medical insurance pooling account, the insured person still needs to bear part of the medical expenses. Therefore, it is advisable to plan your personal finances reasonably and purchase appropriate commercial medical insurance as a supplement.
Cherish resources: The funds in the medical insurance pooling account are limited, and the insured should cherish these resources to avoid unnecessary waste. At the same time, it is important to understand and support the policies that the state has put in place to ensure the basic medical needs of more people.
Healthy living: Preventing the occurrence of diseases is the best way to treat medicine. Maintaining a healthy lifestyle, such as a reasonable diet, appropriate exercise, regular work and rest, etc., is not only beneficial to personal health, but also an effective saving of medical insurance resources.