Outpatient medical reimbursement reform, employee health care is no longer included in the personal account!

August 26, 2020, the National Health Insurance Bureau officially announced about the establishment of a sound employee basic medical insurance outpatient protection mechanism of the opinion draft, the state in order to add protection to our daily life, specially medical insurance reimbursement reform, this time there are three main core initiatives to reform.

One: the general outpatient reimbursement ratio from 50% to establish the outpatient **** financial protection mechanism. The general outpatient clinic to see the common diseases, minor illnesses into the medical insurance integrated fund within the scope of payment, this one is a new medical insurance treatment. In accordance with the provisions of the consultation in the outpatient clinic to carry out a number of surgical procedures are also included in the reimbursement of the integrated fund within the scope of reimbursement, with reference to the hospitalization reimbursement for the management of the conditions of the region to gradually expand the protection of chronic diseases, in the original slow special diseases on the basis of the protection mechanism and the addition of a new step.

Second: the technical approach to the medical insurance personal account has changed accordingly. We all know that the social security by the basic account and personal accounts, social security payments by individuals and enterprises *** with the same commitment, then the corresponding previous health insurance need to pay 2% of the individual, the unit contribution of 30% at the same time credited to the personal account, and now after the reform of the unit part of the payment of health insurance will be unified within the health care insurance fund, and no longer into the personal account, and accordingly, the part of the individual contribution is still counted in the personal account. The first is to make sure that you have a good understanding of what you are doing and how you are doing it.

Third, the scope of use of the individual account for health insurance has been expanded. In order to implement the provisions of the previous basic medical insurance fund, before the medical insurance personal account funds are part of the basic medical insurance, the original can only be used by the employee himself to pay for medical expenses, after the reform of the use of the scope of the expansion of the employee's own medical insurance can be paid for the costs of spouses and children, and other immediate family members; in the past, individual medical insurance account can only pay for the cost of the fixed-point medical institutions, after the reform of the expansion to pay for the costs purchased in the pharmacy. In the past, the individual medical insurance account could only pay for the expenses of designated medical institutions, but after the reform, it will be expanded to pay for the expenses of medicines and medical equipments purchased in pharmacies; at the same time, it can also be used for the personal contributions to the basic medical insurance for urban and rural residents of their immediate families.

After the reform of health insurance treatment will not be reduced, but also will not increase the personal contribution, the outpatient clinic to see minor illnesses into the scope of health insurance coverage, so that the masses of people around the health care services to rest assured, to improve our daily life, for the masses of health considerations. The state optimizes the structure of the individual account, enhance the management of the integrated fund, expand the scope of the fund protection, the amount of money accumulated in the individual account before the reform is still owned by the original part of the individual not to change, after the reform of the individual account does not have the problem of nullification.

The state actively protects the daily needs of our masses, for the sake of our health, for the escort of our good life.