1, with different names: the names of individual account balances and health account balances are different, so are the accounts. The sum of the two is the real amount that the social security card can use;
2. Different scope of use: the balance of health accounts is widely used, and pharmacies can also use it; Personal account balance has a narrow purpose and can only be used in hospital outpatient or hospitalization;
3. There are differences in the flexibility of use: although the balance of health accounts can be used in pharmacies and hospitals at critical moments, the balance of personal accounts does not have this flexibility, and it will be wasted if it is not used up in hospitals;
4. There are differences in the amount of payment: different social security regulations in different places have different personal account balances and health account balances, 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 mutual aid function between family members. Insured employees can establish a family medical 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. By establishing a family medical assistance network, coordinating the use of family members' health account funds, and directly using social security cards in designated medical institutions, mutual assistance can be realized and the burden of out-of-pocket expenses of the whole family can be reduced. 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 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.