Difference between personal account balance and health account balance of medical insurance

The difference between individual account balance and health account balance of medical insurance is as follows:

1, with different names:

Personal account balance and health account balance have different names and accounts, and the sum of them is the real amount of social security card;

2, the scope of use is different:

The balance of health accounts is widely used, and pharmacies can also buy medicines;

Personal account balance has a narrow purpose and can only be used in hospital outpatient or hospitalization;

3. The flexibility of use is different:

Although the balance of health accounts can be used in pharmacies, it can also be used in hospitals at critical moments.

However, the personal account balance does not have this flexibility;

4. Payment amount is different:

The distribution of personal account balance and health account balance is different because of different social security regulations in different places, and the number of personal account balances is more.

Health accounts have three main functions:

1, the function of offsetting some medical expenses paid by yourself. After the establishment of the health account, when the insured goes to the designated medical institutions for medical treatment, they can use the personal medical account to pay the medical expenses according to the provisions of the basic medical insurance, and at the same time, they can use the health account funds to pay the outpatient or inpatient qifubiaozhun (qifubiaozhun) and the personal out-of-pocket expenses above the qifubiaozhun, including the medical expenses of the basic medical insurance, supplementary medical insurance and the part that individuals must pay in the supplementary medical insurance.

2. The role of mutual assistance among family members. Insured employees can establish a family medical assistance network for parents, children and spouse family members who participate in the basic medical insurance for employees or urban and rural residents in this Municipality, and pay medical expenses incurred by family members with insufficient balance of health accounts or no health accounts in designated medical institutions. Through the establishment of family medical mutual aid network, the funds of family members' health accounts are used as a whole, and social security cards are directly used in designated medical institutions to achieve mutual assistance and reduce the burden of out-of-pocket expenses of the whole family. 3. The preventive and health care functions of drug purchase and physical examination. Used to pay for the purchase of drugs, 72 kinds of medical consumables and disinfection products in the designated retail pharmacies; And pay the vaccine expenses and non-public medical expenses for physical examination in designated medical institutions.

Legal basis: Article 23 of the Social Insurance Law of People's Republic of China (PRC).

Employees should participate in the basic medical insurance for employees, and employers 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.