Is it illegal to cash out medical insurance?

It is illegal to cash out medical insurance.

It is illegal to cash out in a pharmacy with a medical insurance card, which belongs to insurance fraud and is suspected of fraud. China's basic medical insurance fund consists of overall funds and individual accounts. The funds in the overall account are managed by the medical insurance center, and the expenses incurred by the insured who meet the local medical insurance reimbursement conditions are paid by the overall account. The funds in this account do not belong to the personal property of the insured. If someone fraudulently uses someone else's medical insurance card to forge medical treatment, hospitalization and other materials to defraud the medical insurance fund for reimbursement, they can be punished as fraud. Personal account funds can only be used to pay medical expenses that meet the basic medical insurance drug list, diagnosis and treatment project scope and medical service facilities standards in designated medical institutions or retail pharmacies. In principle, cash may not be withdrawn.

Medical insurance reimbursement process:

1. Under normal circumstances, when you need to be hospitalized due to illness, you can go to your designated hospital with your medical insurance card and medical records, and settle with your medical insurance card. That is, some of them are paid by themselves, and some medical insurance centers and hospitals reimburse and settle accounts;

2 from designated hospitals to secondary or tertiary hospitals, medical insurance cards can be used for settlement;

3. The patient is critically ill and hospitalized in a non-designated hospital. He should go to the municipal medical insurance center for emergency rescue disease identification within 5 days. After being identified as an emergency rescue disease, he can use the medical insurance card for settlement in the rescue hospital;

4, transferred to other places for treatment, with the consent of the hospital and medical insurance center, the referral procedures. The expenses incurred in the field shall be settled by the individual at his own expense, and after the diagnosis and treatment, the community labor security workstation shall prepare the materials for reimbursement;

5, medical insurance reimbursement is calculated in proportion, generally ranging from 70%. The proportion and amount of reimbursement are related to factors such as self-examination, medication and medical grade;

6. At the time of reimbursement, the insured person needs to prepare relevant materials for hospitalization, such as outpatient medical records, discharge records, discharge diagnosis (disease diagnosis), hospitalization invoices (which can be reported to the outpatient department), general list of hospitalization expenses, and medical insurance statements. If the hospital has done CT, B-ultrasound, electrocardiogram and other inspections, it is also necessary to prepare relevant inspection reports;

7, discharge settlement, submit relevant information, in the medical insurance reimbursement window can be reimbursed. After approval, the reimbursement amount will generally arrive within 15 working days.

To sum up, personal account funds can only be used to pay medical expenses that meet the basic medical insurance drug list, the scope of diagnosis and treatment projects and the standards of medical service facilities in designated medical institutions or retail pharmacies. For the purpose of making profits, taking advantage of the opportunity of enjoying medical insurance benefits, buying medical insurance drugs in excess and reselling them, causing huge losses to the national medical insurance fund, which has constituted the crime of fraud and should be punished according to law.

Legal basis:

Article 88 of People's Republic of China (PRC) Social Insurance Law

Whoever defrauds social insurance benefits by fraud, forgery of certification materials or other means shall be ordered by the social insurance administrative department to return the defrauded social insurance benefits, and a fine of not less than two times but not more than five times the amount defrauded shall be imposed.