The difference between overall payment and medical insurance payment

The differences between overall payment and medical insurance payment are: concept difference, scope difference, payment method difference, payment standard difference and management method difference.

The difference between overall payment and medical insurance payment;

1, which has the same meaning as medical insurance payment, refers to the part reimbursed when seeing a doctor, as opposed to personal payment or cash payment. Overall payment refers to paying part of the medical expenses of the insured person when he sees a doctor with the money in the national medical insurance overall account. The specific payment amount needs to be calculated according to the reimbursement ratio of the insured.

2. Overall payment or medical insurance payment is not unconditional payment. Threshold fees will be set in most areas. This threshold fee varies from region to region, and is usually several hundred yuan. Within this fee, the overall payment will not be activated, and all expenses will be paid from the personal account of medical insurance, which belongs to the full self-sufficiency stage.

Medical insurance cannot be reimbursed after overall payment:

The overall payment of medical insurance means that the medical insurance reimbursement is finished. For example, pay 3 yuan from personal account, deduct money from social security card, or pay cash directly with social security card, and be reimbursed in real time when paying. The overall payment of medical insurance is medical insurance reimbursement, and the remaining out-of-pocket expenses are deducted from the social security card first, and then the cash is paid after deduction.

I hope the above content can help you. Please consult a professional lawyer if you have any other questions.

Legal basis: Article 25 of People's Republic of China (PRC) Social Insurance Law.

The state establishes and improves the basic medical insurance system for urban residents. The basic medical insurance for urban residents combines individual contributions with government subsidies. People who enjoy the minimum living guarantee, disabled people who have lost their ability to work, elderly people and minors over 60 years old in low-income families, etc. , subsidized by the government.