1. The health account can buy medicine at the designated pharmacy within the scope stipulated by social security, and the personal account balance is deducted first when the hospital outpatient service is settled, and the unpaid part can be paid by the health account; Personal accounts are used for outpatient or inpatient treatment in designated hospitals.
2. The amount issued by the health account will be less than that of the individual account. The above is the difference between health accounts and personal accounts, both of which are social security account classifications.
Social security health account refers to the fund account set aside from the actual balance of the insured's personal medical account for comprehensive health protection among himself, his parents, children and his spouse.
Personal social security account means that the social insurance agency establishes a social security number for each person who participates in social endowment insurance according to the State Bureau of Technical Supervision, and records the endowment insurance premium transferred by the unit according to the regulations and all the endowment insurance premiums paid by the individual, which serves as the basis for calculating and distributing the endowment insurance premium in personal account when the person who participates in social endowment insurance retires.
Medical insurance settlement procedure
(1) Settlement procedures for inpatient and outpatient treatment of special diseases
Designated medical institutions shall submit the expense list, hospitalization list and related materials of discharged patients last month to the medical insurance agency before 10 every month, which will be used as the basis for monthly pre-allocation and year-end final accounts after examination. The medical insurance agency pre-allocated the hospitalization and outpatient expenses for special diseases last month.
Insured persons who have been identified as suffering from special diseases shall go to the designated medical institutions designated by the labor and social security departments for medical treatment and medicine purchase, and the medical expenses incurred shall be directly recorded and settled immediately.
(2) Emergency settlement procedures
The medical expenses incurred by the insured due to emergency rescue to non-designated medical institutions in the city and medical institutions in different places shall be paid in advance by individuals or units. After the emergency rescue, the medical insurance agency shall handle the reimbursement procedures according to the provisions with the emergency hospitalization medical records, inspection, laboratory test sheets, invoices and detailed list of medical expenses.