Provisions of Zhuhai Municipality on the Payment Period of Medical Insurance

Zhuhai Medical Security Management Center, human resources and social security departments and financial departments of all districts (economic functional areas):

According to the spirit of the 2022 Report on the Work of the Government and the Notice of the Ministry of Finance and the National Health Insurance Bureau of State Taxation Administration of The People's Republic of China on Doing a Good Job in the Basic Medical Insurance for Urban and Rural Residents in 2022, combined with the actual situation of this Municipality and with the consent of the Municipal People's Government, we hereby notify the students that the financing standards for minors and urban and rural residents to participate in the basic medical insurance for urban and rural residents in our city are adjusted as follows:

First, the financial subsidy standard for residents' medical insurance will be added in 2022.

In 2022, the financial subsidy standard for students, minors and urban and rural residents participating in the medical insurance for residents in our city will be raised from 70 yuan to 720 yuan per person per year, and will be borne by the municipal and district finance in accordance with the proportion stipulated by the municipal government.

Two, 2023 residents' medical insurance payment standard

In 2023, students, minors and urban and rural residents who participate in the medical insurance for residents in our city will receive financial subsidies for 720 yuan every year, which will be borne by the municipal and district finance in accordance with the proportion stipulated by the municipal government. The individual payment standard for students and minors is 350 yuan per person per year; The individual payment standard for urban and rural residents is 500 yuan per person per year.

Three, the city's college students insured provisions

College students studying in this city every year will be insured by the school during the centralized insurance period, and the basic medical insurance premium for the following year will be withheld, and they will enjoy the medical insurance benefits from February 1 to 1. Among them, the new college students who did not participate in the residents' medical insurance in this city in autumn will pay the basic medical insurance premium for the next year, and the treatment period is from September of that year 1 to February of the following year 1. The social security year changes the transition period of the medical insurance year (202 1 the second half of the year), and the college students who have paid the fees can choose to withhold the basic medical insurance premium of the following year in the graduation year, and the treatment period is 1 to the following year1; You can also choose to withhold the basic medical insurance premium in the first half of the following year, and the treatment period is 65438+ 10 1 to June 30th of the following year.

Fourth, the adjustment of residents' medical insurance benefits.

(1) The scope of payment for general outpatient service shall be implemented in accordance with the catalogue of basic medical insurance drugs, the catalogue of medical consumables and the catalogue of diagnosis and treatment items in Guangdong Province.

(II) Within the scope of the policy of co-ordinating designated medical institutions for medical treatment in selected general outpatient clinics, the maximum payment limit for each medical insurance year is not set, and it will be paid by the co-ordination fund according to the proportion of 80%, and the signing of the family doctor service package agreement will be increased by 5 percentage points accordingly.

(three) the outpatient medical expenses within the scope of the first aid and rescue policy shall be paid according to the proportion of hospitalization and included in the accumulated medical expenses of the approved hospitalization.

(4) If the insured person needs to be referred to the designated medical institutions at the second level or above in this Municipality for medical treatment due to his illness, he can go to the referral medical institution for medical treatment with the consent of the designated medical institutions that sign the general outpatient service, and implement online settlement, and each referral is valid for 30 days; If it is necessary to continue referral or re-referral due to illness during the referral period, the referral procedures shall be re-handled.

(five) in addition to first aid and rescue, the insured without referral to non-selected medical institutions for outpatient treatment, the overall fund will not be paid.

Verb (abbreviation of verb) implementation time

This notice shall be implemented as of the date of issuance, in which the adjustment of residents' medical insurance benefits and the economic security reform of Zhuhai basic medical insurance outpatient service shall be implemented simultaneously. If the previous relevant provisions are inconsistent with this notice, this notice shall prevail.

This notice is valid for five years.