The analysis is coming, the new medical insurance policy has begun, how to use the medical insurance

Seek medical treatment and hospitalization in designated hospitals. Medical expenses that are not covered by medical insurance reimbursement and need to be borne by individuals can be paid with medical insurance personal accounts.

You can reimburse through your personal account, or you can buy drugs through your personal account, so that you can use it better.

In addition to the personal account of medical insurance, you can also use it for your own family.

2022 Beijing Medical Insurance Personal Account Latest Policy 1: From December 1, the personal account can be insured for the whole family with inclusive insurance.

Starting from December 1 (today), the Beijing medical insurance personal account can be used to enroll the whole family in inclusive insurance, and the balance of the medical insurance personal account is allowed to pay premiums. When making a payment, you can select the "Individual Account Payment" button to confirm the payment.

In 2022, the latest policy of Beijing medical insurance personal account II: three types of people can participate in insurance.

In 2022, only family members can enjoy the personal account of Beijing medical insurance, and family members refer to the spouses, parents, and children of the insured persons.

2022 Beijing Medical Insurance Personal Account Latest Policy 3: Two conditions must be met when paying.

Spouses, parents, and children must be insured persons of the city's basic medical insurance before using their personal accounts to pay premiums, and must be recorded, which can be handled through the Beijing medical insurance public service platform.

According to the notice of the Beijing Municipal Medical Security Bureau on adjusting the dust barrier policy of the basic medical insurance for urban employees in the city, it is stated that from September 1, 2022, the basic medical insurance premiums paid by in-service employees will be fully credited to their personal accounts, and the inclusion standard is 2% of the base amount of their participation in the insurance, and all the basic medical insurance premiums paid by the employer will be included in the overall planning**; The personal accounts of retired personnel continue to be allocated by the overall coordinator according to the quota, and the specific inclusion standards are: those who are not under the age of 70 are classified according to the monthly standard of 100 yuan, and those who are over 70 years old (inclusive) are classified according to the monthly standard of 110 yuan.

From January 1, 2023, the outpatient (emergency) medical expenses incurred by the insured persons in a year that meet the payment regulations of the city's basic medical insurance, and the maximum payment limit is more than 20,000 yuan, 60% of the large medical expenses will be paid by the mutual aid fund for large medical expenses, and there is no upper limit.

From 2022 onwards, the minimum payment standard for serious illness medical insurance for urban employees will be the same as that for urban and rural residents, which will be adjusted to 30,404 yuan.

Hello dear! The new regulations on personal medical insurance accounts are as follows: personal accounts are mainly used to pay the out-of-pocket expenses of insured persons within the scope of medical insurance policies.

It can be used to pay for the medical expenses borne by the insured and his spouse, parents and children in designated medical institutions, as well as the expenses incurred by individuals in the purchase of drugs, medical devices and medical consumables in designated retail pharmacies. Explore personal accounts for spouses, parents, and children to participate in urban and rural residents' medical insurance. Regulate the expenses that are not within the scope of medical insurance protection in accordance with the law.

1. The new policy of 2022 medical insurance card mainly includes three aspects:

1. Enhance the function of outpatient mutual aid. Starting from outpatient chronic diseases such as hypertension and diabetes, which are burdened by the masses, the general outpatient medical expenses for frequent and common diseases will be gradually included in the scope of overall payment. The general outpatient clinic covers all employees and medical insurance participants, and the payment ratio starts from 50%, and the level of protection is gradually improved with the enhancement of the affordability, and the treatment payment can be appropriately tilted towards retirees.

Once the co-payment mechanism for general outpatient services is established, especially when the co-payment ratio is increased from 50% to 70%, it means that the outpatient expenses can be paid by the co-ordinator** without difference, just like the inpatient expenses. This is extremely important and effective in reducing the outpatient burden of employees, especially retired employees and employees in difficulty.

2. Improve the method of crediting personal accounts. All unit payments are included in the overall planning**, and are no longer partially transferred to personal accounts; In principle, individual payment shall not exceed 2%, which is not only to reduce the burden of individual payment, but also to enhance the mutual aid and sharing function of outpatient payment.

3. Standardize the scope of use of personal accounts. The personal account can be used for mutual assistance and mutual assistance among immediate family members. In this way, it can not only improve the mutual assistance and mutual aid ability of outpatient payment among family members, but also reflect the self-protection function of the family.

2. The new policy on the reimbursement ratio of medical insurance in 2022:

1. Medical insurance is mainly divided into employee medical insurance and resident medical insurance, and the reimbursement ratio is also different;

2. The reimbursement ratio of employee medical insurance is divided according to the level of hospitalization expenses, the reimbursement ratio between 1,300 yuan and 30,000 yuan is 85, the reimbursement ratio between 30,000 yuan and 40,000 yuan is 90, the reimbursement ratio between 40,000 yuan and 100,000 yuan is 95, and the reimbursement ratio between 100,000 yuan and 300,000 yuan is 85;

3. Residents' medical insurance is composed of the merger of urban residents' medical insurance and NCMS. The reimbursement ratio is 65 for first-class hospitals, and the starting line is 300 yuan; The reimbursement ratio of secondary hospitals below 6,000 yuan is 65, and the reimbursement ratio of more than 6,000 yuan is 80, of which the starting payment line for county secondary hospitals is 400 yuan, and the starting payment line for municipal secondary hospitals is 600 yuan.

Legal basis: Social Insurance Law of the People's Republic of China

Article 23.

Employees shall participate in the basic medical insurance for employees, and the employer and the employee shall jointly pay the basic medical insurance premiums in accordance with the provisions of the state.

Individually-owned businesses without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexibly employed persons may participate in the basic medical insurance for employees, and the individual shall pay the basic medical insurance premiums in accordance with the provisions of the state.

2021 Medical Insurance Reform After the Personal Account Crediting Measures:

The personal account of the in-service employee shall be included in the basic medical insurance premiums paid by the individual, and the inclusion standard shall be controlled at 2% of the base of the insurance payment in principle, and the basic medical insurance premiums paid by the unit shall be included in the overall planning **, and shall no longer be included in the personal account of medical insurance; In principle, the personal account of retirees shall be allocated by the overall ** according to the fixed amount, and the amount will be gradually adjusted to about 2% of the average level of the basic pension in the year when the reform is implemented in the overall planning area according to this opinion.

The specific proportion or standard of personal account shall be determined by the provincial medical insurance department in conjunction with the financial department in accordance with the above principles, and the overall planning area shall be determined in combination with local actual research. After the overall planning and personal account structure are adjusted, the increased overall planning is mainly used for outpatient mutual aid protection and improving the outpatient treatment of insured personnel.

China's current personal medical insurance account classification standards:

The basic medical insurance consists of a co-ordination plan and an individual account. The basic medical insurance premiums paid by individual employees shall be fully credited to their personal accounts. The basic medical insurance premium paid by the employer is divided into two parts, one part is used to establish the overall plan, and the other part is transferred to the personal account.

The proportion of the personal account is generally about 30% of the employer's slow payment, and the specific proportion is determined by the overall planning area according to the scope of payment in the personal account and the age of the employee.

That is to say, in the past, the money in the personal account of medical insurance was all of the individual medical insurance payment and 30% of the unit medical insurance payment. After this reform, all the unit payment parts are included in the overall planning**.