The difference between health account and personal account of medical insurance

Legal analysis: Health account generally refers to the fund account drawn from the actual balance of the individual medical account of the insured person of basic medical insurance for comprehensive health protection between himself, his parents, children and spouse. Personal account is a special medical insurance account set up by social insurance agencies for insured employees, which is used to record and store personal account funds. At present, the specific scope of use of medical insurance personal accounts and health accounts is different in different places. For example, Xiamen health account and personal account can be used simultaneously in pharmacies and hospital outpatient departments. However, Qingdao has made a strict distinction between the use of personal accounts and health accounts and cannot use them at the same time.

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

Twenty-third employees should participate in the basic medical insurance for employees, and the employer and employees should jointly pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.

Article 25, paragraph 2: The basic medical insurance for urban residents shall be based on the combination of individual contributions and government subsidies.

Twenty-eighth medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency treatment and rescue shall be paid by the basic medical insurance fund in accordance with state regulations.

Measures of Xiamen Municipality on the Administration of Health Accounts of Medical Insurance

Article 8 After the establishment of the health account, the insured still uses the personal medical account to pay the medical expenses according to the provisions of the basic medical insurance, and can also use the health account funds to pay the expenses stipulated in Articles 6 and 7 of these Measures.

Article 9 The carry-over and inheritance of health accounts shall be carried out in accordance with the relevant provisions on the management of individual medical accounts of basic medical insurance. If the insured person transfers the basic medical insurance relationship due to reasons such as transferring out of the city, the actual balance of his health account will be merged into the personal medical account and transferred together with the basic medical insurance relationship.

"Measures for the Administration of Individual Accounts of Basic Medical Insurance for Employees in Qingdao" Article 3 The scope of individual account payment: (1) Medical expenses incurred by myself or his immediate family members in designated medical institutions in our city that should be borne by individuals according to the provisions of social medical insurance. (two) I or its client in the city designated retail pharmacies credit card consumption in line with the provisions of the cost. (three) I or his immediate family members to participate in the social medical insurance and supplementary medical insurance in our city should be borne by the individual.