This cost can be reimbursed!Good news from Nanchang employee medical insurance!

Author:Jiangxi Daily Time:2022.07.22

A few days ago, Nanchang issued the "Implementation Rules for the Implementation Mechanism of the Basic Medical Insurance Clinic of employees in Nanchang City", which clarified that starting from January 1 next year, the general outpatient expenses of employees in Nanchang's employees were officially included in the scope of the overall fund payment. This means that at that time, the expenses of employees' medical insurance insurers will be reimbursed due to ordinary outpatient clinics.

The so -called ordinary outpatient help refers to the ordinary outpatient expenses of employees' medical insurance insured personnel. It used to be mainly guaranteed by personal accounts. It is now guaranteed by the protection, that is, reimbursement through overall plans. "The core of this medical insurance reform is the transformation from the original personal accumulation guarantee model of the original outpatient medical expenses to the fund's award -style guarantee model." The relevant person in charge of the Municipal Medical Insurance Bureau introduced that after the reform of the employee medical insurance outpatient protection protection reform of Nanchang Municipal Medical Insurance Bureau It will increase the reimbursement of ordinary outpatient medical insurance for employees and increase family accounts for personal accounts.

It is understood that in terms of ordinary outpatient treatment, Nanchang City clearly stipulates that within a natural year, the general outpatient clinic of employees' medical insurance is 600 yuan; The institutions were determined to be 60%, 55%, and 50%, and the highest payment limit of the year was 1,800 yuan. The proportion of retirees has increased by 5 percentage points, and the maximum payment limit is increased to 2,000 yuan.

At the same time, the balance of the personal account of the insured employees can be associated to the spouse, parents, and children (hereinafter referred to as affiliated people) to pay for the cost of personal burden that the personal burden generated by the medical institution outpatient medical institution.

It is worth mentioning that the basic medical insurance premiums paid by the unit are no longer included in personal accounts, and all of them are included in the overall fund; the personal account of the employee (including flexible employment) is included in 2%of the payment base for the insurance payment; retirees The personal account was divided by the overall funding fund according to the quota, and the quota was 2.5%of the average level of basic pensions in the province that year.