Those things about social insurance | Can retired employees pay for medical insurance?How to reimburse?

Question: I am a retired female employee, and the basic medical insurance for employees has paid a total of 20 years. In February this year, I was hospitalized for illness and spent a sum of money. The hospital told me that the reimbursement standard for medical expenses to be complied with the prescribed medical expenses was reduced. What is the reason?

Answer: According to the current regulations of Hainan Province, retirees who participated in the basic medical insurance (hereinafter referred to as employee medical insurance) who participated in urban employees (hereinafter referred to as employee medical insurance) have accumulated a total of 30 years for men and 25 years of women, and they can enjoy employee medical insurance treatment in full. Reimburse 90%. With a cumulative payment period of less than 30 years and women who have not been in the 25 years, each decrease is reduced by 1 year, and the medical insurance treatment standards they enjoy will be reduced by 3%accordingly. The medical insurance for women's participants has paid a total of 20 years. In accordance with a decrease of one year, the standards of enjoying employee medical insurance treatment standards are reduced by 3%, and the treatment standards for participants have been reduced by 15%. Therefore, the reimbursement of hospitalization compliance medical expenses is 75%, which is slightly lower than full enjoyment.

Question: My situation is exactly the same as the elder sister above. Men who have not paid for the medical insurance for retired employees have not paid for 30 years and women have not paid for 25 years. Can they pay for medical insurance premiums?

Answer: In accordance with the policy and regulations, retirees participating in the basic medical insurance for employees, who have paid a period of payment for less than 30 years and women have less than 25 years, they can pay the basic medical insurance premiums that should be paid at one time. After completing the payment period, you can reimburse the prescribed medical expenses in full. The payment standard is determined to make up the payment standards of flexible employment of the year.

For example, Aunt Wang pays for 20 years before retirement, then Aunt Wang can pay 5 years of medical premiums to meet the conditions for paying for 25 years, and she can enjoy medical insurance treatment in full. If Aunt Wang decides to pay this year, the monthly payment base is 6543 yuan, the rate of 6%, the monthly payment is 392.58 yuan, and a total of 23554.8 yuan is required for 5 years.

Question 3: Can retired employees make up for medical insurance premiums and medical expenses that have been cured before replenishment?

Answer: According to the current policies, employees pay the medical expenses incurred before the remaining medical insurance premiums at one time, and the overall funds will not pay. Assuming that the retirement staff, Aunt Wang, pays the medical insurance premiums that should be paid in May this year. After the retirement of Aunt Wang, the medical expenses that had been cured before the payment had been paid in accordance with the reimbursement standards when the expenses occurred. Because the reimbursement standards after the repayment did not trace back, the overall funds did not reimburse the medical expenses before the payment was paid.

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Source | Hainan Daily Client

Edit | Yin Yingzi

Editor in charge | Wu Qirong

Duty header | Zhong Ye

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