The Difference Between Individual Out-of-Pocket and Individual Self-Care

After the treatment costs, many people look at the health insurance reimbursement invoices on the individual self-pay, individual self-care, individual self-pay, often confused

Medical expenses invoices

The following we use a simple mind map, which explains:

The social insurance reimbursement Thinking Guide

1, personal out-of-pocket expenses: refers to the medical insurance settlement outside the scope of the costs, including out-of-pocket drugs (Class C drugs), out-of-pocket services and out-of-pocket medical treatment, this part of the cost does not belong to the social security medical reimbursement within the scope of the costs, need to be personally settled in cash (including bank transfers, micro-credit and Alipay payment and other ways).

2, personal care: refers to part of the cost of the project in accordance with the provisions of the part borne by the individual, the first by the insured person in accordance with the prescribed proportion or difference in payment, such as part of the Class B drugs 90% into the reimbursement scope, 10% need to be borne by the individual, although belonging to the medical insurance settlement of the cost of the scope of the expenses, but need to be settled in cash by the individual (including bank transfers, WeChat and Alipay, and other ways).

3. Individual out-of-pocket expenses: medical expenses deducted from the individual's out-of-pocket expenses and the individual's own part of the cost, and then according to the proportion of the basic medical insurance regulations borne by the individual. Including the costs below the starting line, the costs above the ceiling line, and the part of the reimbursement rate borne by the individual and other three items.

The cost of treatment is reimbursed in the practice of social security reimbursement, after deduction of personal out-of-pocket expenses and personal expenses, and then reimbursed according to the proportion of the basic medical insurance, paid by the general fund or the local supplementary fund, with limited reimbursement rate. The need for consultation services, the use of effective Class C drugs and so on are not covered by the social security system, so you want to have a good medical service without worrying about, and then buy a suitable commercial insurance is particularly important.