Official announcement!The outpatient cost can be reimbursed!Comprehensive implementation in Henan Province

Dahe newspaper, Yu video reporter Zhang, look at

On July 5th, at the special press conference of the "Henan Province Establishing and Improvement of the Great Protection Mechanism of the Basic Medical Insurance Clinic" held at the Press Office of the People's Government of Henan Province, Zheng Zijian, Secretary of the Party Group and Director of the Henan Provincial Medical Security Bureau, said that from this year, this year, this year From July 1st, in the province of Henan Province, the guarantee of the outpatient facilities of employees in Henan province will be reimbursed by incorporating ordinary outpatient costs into the overall fund, reducing the burden of medical expenses for insured persons, especially the elderly outpatient clinics, further strengthening the guarantee function of medical insurance funds, improving The use efficiency of medical insurance funds.

The implementation of this reform is mainly to establish a general outpatient clinic overall planning, and incorporate medical expenses in the medical insurance directory incurred by the insured persons into the scope of reimbursement of the overall fund reimbursement. After the reform, the reimbursement ratio of the medical expenses policy in the medical insurance directory in our province can reach more than 50%, the annual reimbursement limit of the employee is around 1,500 yuan, and the retirees are around 2,000 yuan. According to statistics and calculations, the average peripheral medical expenses of employees in the province are around 1900 yuan each year.

The unit payment part is no longer included in personal account

The reform and adjustment of the overall fund and personal account structure, focusing on improving the measures of employee medical insurance personal accounts, properly expanded the scope of use, and improved the management of personal account usage. The personal payment part of the employee is still included in my personal account, that is, it is included in the personal account according to the 2%of my payment base. The quota is distributed, and the amount is about 2%of the average basic pension of the previous year, and the province's monthly includes about 60 yuan per capita.

Personal account realizes the "small communist" between family members

This reform will allow family members to use their personal accounts to use personal accounts. They can use personal accounts to pay for family members' self -paid medical expenses for family members. Essence At the same time, the personal account of employee medical insurance can pay a large amount of medical supplementary insurance premiums and pay the medical insurance premiums for family members. In addition, the "Implementation Opinions" clarify that personal accounts must not be used to pay for public health, fitness or health care, which are not belonging to the scope of basic medical insurance protection.

Personal accounts can pay residents' medical insurance premiums for family members

The reporter learned that since the implementation of the "Implementation Opinions", Henan Provincial Workers' Medical Insurance has achieved direct settlement and medical institutions in the outpatient clinics and direct settlement in provinces and inter -provincial and different places, and simultaneously realized the personal account of employees in designated pharmacies. Purchase drugs, medical consumables and medical devices for family members. By September to December, the concentrated payment season for urban and rural residents will be able to realize the medical insurance premiums of residents with personal accounts to use personal accounts. In addition, since July 1, the province's medical insurance for employees has enjoyed 116,300 people's overall treatment benefits in accordance with new policies, and the expenditure of 11.073 million yuan in overall funds has been presented.

Responsible editor: Shi Jian | Audit: Li Zhen | Director: Wan Junwei

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