What do you mean by self-payment and self-payment in medical insurance?

Self-payment in medical insurance refers to the proportion of self-payment stipulated in medical insurance; Out-of-pocket refers to the use of drugs and examinations in hospitals. According to the medical insurance regulations, the proportion of patients' out-of-pocket expenses is: general drugs 10%, and examinations are 8%!

Out-of-pocket refers to consumption items that cannot be reimbursed under the condition of purchasing social security or medical insurance, that is to say, those who want to pay for themselves cannot be reimbursed. Self-payment refers to the money paid in advance by oneself. If anyone buys social security or medical insurance, they can take the invoice to the relevant departments for reimbursement, which can be reimbursed.

The HIS system and medical insurance system of the hospital may identify the medical care or consumables inside and outside the medical insurance catalogue, so there are Class A, Class B and Class C (at their own expense). In another case, medical insurance shows "employee medical insurance" or "resident medical insurance", and those who are not insured show "at their own expense". The out-of-pocket part is the amount of money actually spent on hospitalization expenses.

1. Out-of-pocket 1: The money that patients need from the expenses within the scope of medical insurance reimbursement.

2. Out-of-pocket 2: Some drugs and tests are marked as "partial out-of-pocket", and the amount that patients need to pay.

For example, a bottle of 200 yuan's medicine belongs to this kind of medicine. If the out-of-pocket ratio is 10%, then you have to bear the 20 yuan.

3. Self-funded: Simply put, medical insurance cannot be reimbursed, and you need to pay for it yourself.

Medical insurance deductible: it is the minimum standard for medical insurance reimbursement. The part below the deductible needs the patient's own responsibility, and the medical expenses beyond the deductible can be reimbursed through medical insurance. The general medical insurance deductible is several hundred dollars.

Medical insurance capping line: it is the highest amount that medical insurance can reimburse, and the patient will be responsible for it in the future.

The top line of medical insurance outpatient service is generally around 20,000, and the top line of hospitalization can reach 65,438+10,000 or even 200,000.

At your own expense: at your own expense means that you need to pay for it yourself. Below the general deductible line and above the capping line, some Class B drugs and all Class C drugs need to be paid at their own expense.