Beijing: The use of personal medical insurance accounts will be used next month

The Beijing Municipal Medical Insurance Bureau issued the "Notice on Adjusting the Graduate Policies for Adjusting the Basic Medical Insurance of the Urban Employees in the Municipality" yesterday. It is clear that starting from September 1, 2022, the city's medical insurance personal account funds are used for directional use, and insured persons cannot be freely withdrawn. Since 2023, the treatment of employees in the city's medical insurance will not be sealed.

At present, the medical insurance participants in this city have occurred in accordance with the cities (urgent) diagnosis expenses that comply with the city's basic medical insurance payment. The maximum payment limit is 20,000 yuan, which exceeds 20,000 yuan. According to the notice, starting from January 1, 2023, the maximum payment limit of employee medical insurance clinics will no longer be set up, and the reimbursement ratio of less than 20,000 yuan will remain unchanged; 60%of the employees of more than 20,000 yuan will be reimbursed. Uniformly supplemented medical insurance), not capped. It is expected to benefit 170,000 insured persons each year and reduce the burden on the insured by about 1 billion yuan.

According to the state's requirements for the management of basic medical insurance funds, personal account funds shall be dedicated to special funds. From September 1st, the city's medical insurance personal account funds have implemented bookkeeping management. Insured personnel cannot be freely withdrawn and achieved targeted use. It is mainly used to pay the medical expenses incurred by the insured employees in designated medical institutions or designated retail pharmacies. Before September 1st this year, personal account funds in medical insurance passbooks will be available at any time in the future. The Municipal Medical Insurance Bureau stated that it will gradually accumulate through personal account funds to form medical reserves, solve the burden of medical expenses of individuals and family members, and enhance the ability to resist risk.

In order to further reduce the burden of medical expenses of patients with major illnesses, since 2022, the standard for employee's major disease protection starting standard has been reduced from 39,525 yuan to 30,404 yuan. After enjoying the basic medical insurance benefits of urban employees, the insured persons have a “second reimbursement” of the medical expenses of the annual outpatient and inpatient personal self -payment of the annual outpatient and hospitalization, which exceeded the part of the payment standard and the medical insurance for the general illness of the urban employee. The starting standards of less than 50,000 yuan (that is, 30404 yuan to 80404 yuan) are reimbursed 60%, and 70%of the 50,000 yuan (ie 80404 yuan) or more are reimbursed, and the top is not capped. It is expected to benefit 35,000 insured persons each year and reduce the burden of 120 million yuan for the insured persons.

Since September 1, 2022, all the basic medical insurance premiums paid by the employer are included in the overall fund, and all the basic medical insurance premiums paid by the employees are included in the personal account, and the payment ratio is unchanged; The quota is divided, and the current standard is still implemented. The 70 -year -old (excluding) is below 100 yuan per month, and the age of 70 is included in 110 yuan per month.

Starting from December 1, 2022, spouses, parents, and children who are allowed to participate in the basic medical insurance of the city to use personal account funds for the use of family members, and pay the relevant expenses stipulated in the scope of personal account use that incurred by the people and the objects of a lot of money, and and of. You can use personal accounts to participate in the basic medical insurance and long -term care insurance payment of urban and rural residents in the city, and purchase supplementary medical insurance for the city (this stage specifically refers to the "Beijing Inclusive Health Insurance"). Use family members to use personal accounts to reduce the burden on family cash payment, and build a new guarantee mechanism of "I am a family and family for me". The spouse, parents, and children of the insured persons should first use my personal account funds when using the personal account of the insured in designated medical institutions or fixed -point retail pharmacies, and then use the personal account funds of others in the order of filing.

The Municipal Medical Insurance Bureau reminded that from September, from the 1st to 5th of each month, the medical insurance agency will complete the work of the personal account of employees and retirees in accordance with the medical insurance premiums. After that, the insured can inquire about personal account funds in the Beijing medical insurance public service platform "I want to check" menu, the official website of the Municipal Medical Insurance Bureau, or the window of various districts. (Source: Beijing Daily)

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