Where can I use personal account funds?How to calculate interest?Can I still use it after changing my work?Answer

Since September 1, 2022, Beijing's medical insurance personal account has achieved targeted use. The funds in the personal account are implemented, and the insured cannot be freely withdrawn. The funds that have been entrusted to the medical preservation before September 1 can still be withdrawn at any time.

my country's basic medical insurance is implemented

The combination of social overall planning and personal account

According to relevant regulations

Basic Medical Insurance Personal Account

Economic and insurance agency by municipal medical insurance

Establish an employee and retirees for the basic medical insurance for urban employees

What is the monthly number of personal account funds?

Where can the funds of personal accounts be used?

What is the interest?

Please look down! Intersection Intersection

How to calculate the funds of the medical insurance personal account that month?

From September 1st, before the 5th of each month, the municipal medical insurance agency will complete the entry of the personal account of employees and retirees in accordance with the medical insurance premiums.

After the personal accounts are adjusted, the basic medical insurance premiums paid by working employees in Beijing will be included in the personal account. The standard is 2%of the basis for the payment of the insurance payment. In the personal account of the employee, all are included in the overall fund. The personal account of retirees is classified by the overall planning fund according to the quota, and the standards are classified as the original specified quota, that is, the 70 -year -old (excluding) below 100 yuan/month, and at the age of 70 or more at 110 yuan/month, enter the entrance Essence

How to calculate the interest of the medical insurance personal account?

It is understood that the principal and interest of the insured's medical insurance account is owned by individuals and can be used for use.

According to Article 22 of the "Beijing Municipal Basic Medical Insurance Regulations" (Beijing Municipal People's Government Order No. 158): "Personal account storage amount is calculated in accordance with the annual bank residents' interest rate interest rates." Since September 1, 2022, the basic medical insurance personal account pays interest on quarterly, and interest is incorporated into personal account balance.

Where can the funds of personal accounts be used?

(1) The funds of the personal account can pay the insured persons within the scope of the policy scope of fixed -point medical institutions or fixed -point retail pharmacies; ) Medical expenses that are affected by personal burden of medical institutions in a designated medical institution, and the cost of personal burden that are affordable by individuals that occur in drugs, medical devices, and medical consumables at designated retail pharmacies; Health insurance products.

(2) The funds of the personal account can also be used to pay the insured person and their spouse, parents, and children to participate in the city's urban and rural residents' basic medical insurance and long -term care insurance for personal payment.

(3) Personal accounts shall not be used for public health expenses, sports fitness or health care consumption, etc., which are not expenditures that do not belong to the scope of basic medical insurance protection.

The Haidian District Medical Insurance Bureau reminds that insured persons need to record or change the amented objects in advance. After the filing, the personal account starts the airspace function. When the insured uses personal account settlement and payment of medical expenses, first deducts his personal account and then deducts the airspace account. The balance of the personal account (including the Joji account) is insufficient, and the personal cash is paid. The sequence of the deduction of the amented account is determined by the aid objects by itself. If the object of relief uses the refunds after the use of his own and the a little bilateral account after the targeted pharmaceutical institution, after purchasing the medicine, in principle, it will be refunded according to the original channel.

What conditions should family members use personal accounts?

(1) The spouse, parents, and children of the insured person, and the basic medical insurance insured person in the city.

(2) Eligible family members must be recorded. When using the personal account of the insured person in a designated pharmaceutical institution, you should first use his personal account funds, and then use the funding account in the filing order.

When urban employees flow across the unified area, can personal account funds be used?

When employees flow across the unified region, if the basic medical insurance relationship is transferred to the business, other personal account funds transferred into the city's personal account are merged into the city's personal account to uniform management; Transfer to the new insurance overall plan.

Can employee medical insurance interrupt payments or change to the basic medical insurance for urban and rural residents, can I still use personal account payment fees?

According to the relevant person in charge of the Haidian District Medical Insurance Bureau, when the individual participation of employees 'medical insurance participants changes, such as participating in the city's urban and rural residents' medical insurance, participating in the city's employee medical insurance or no longer participating in insurance, the balance of personal accounts, the balance of personal accounts You can still pay the relevant expenses of the spouse, parents, and children who have recorded in accordance with regulations.

The reform of the forensic protection mechanism of the outpatient clinic has improved the outpatient guarantee standards. 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, and the reimbursement of retirees will be reimbursed by 80%. Insurance), do not cover it.

It is understood that Beijing established a medical security mechanism for urban employees in 2020. After the insured employees enjoy the basic medical insurance benefits of urban employees in the previous year, the cumulative personal payment medical expenses of an annual outpatient and hospitalization have exceeded the above payment standards above the payment standards. The part of the urban employee is "second reimbursement". With a starting payment standard of less than 50,000 yuan, 60%of the medical insurance for serious illness, 70%of the reimbursement of more than 50,000 yuan, will not be capped. The reform also reduced the starting payment standard for employees' general illness protection. Since 2022, the starting payment standard for urban employee's major illness protection is reduced from the original 39525 yuan to 30,404 yuan, which is consistent with the starting standard of major illness insurance for urban and rural residents. The District Medical Insurance Bureau stated that the adjustment of the structure of the overall fund and personal account will break through the limitations of insufficient personal account protection function, insufficient a good luck, and inadequate burden, and promote the protection of employee medical insurance clinics. The model turns to the social support guarantee model. On the basis of not increasing the proportion of units and individuals, it will play a greater extent to play the function of social airspace and further improve the level of fund use efficiency and treatment guarantee.

Reporter: Guan Yiping

Edit: Zhang Bin

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