Beijing Social Security Card September 1 What's the new policy?

On August 19, 2022, Beijing Municipal Medical Insurance Bureau issued the document "Notice on Adjusting Relevant Policies of Basic Medical Insurance for Urban Employees in this Municipality", which greatly adjusted Beijing's medical insurance policies. Let's see what changes have taken place.

Change to 1. Medical insurance personal account funds can not be withdrawn.

According to the requirements of the state for the special use of personal account funds, since September 1 day, 2022, personal account funds will be subject to bookkeeping management, and the funds will be earmarked for special purposes, so the insured personnel cannot withdraw them.

Previously, part of the medical insurance premiums paid by Beijing employees will be deposited in the medical insurance passbook, and the insured can withdraw cash directly from the passbook without any restrictions.

This policy is very humane, because young people are in good health and there is almost no cost to see a doctor. Even if they pay according to the minimum base, more than 1000 medical insurance passbooks are recorded every year.

However, from September 1 day, 2022, personal account funds will be subject to bookkeeping management, and the insured can't withdraw them freely, so they can only use them to buy medicine or see a doctor.

In fact, there are only two cities that support the withdrawal of medical insurance: Beijing and Tianjin.

On February 3, 20021,65438+,the General Office of Tianjin Municipal People's Government issued the "Implementation Measures on Improving the Economic Security System for Staff Outpatients", stipulating that:

From June 5438+1 October1day, 2022, the personal account funds of employees' medical insurance will no longer be transferred to the bank card, but will be transferred to my personal account ledger for medical treatment and medicine purchase.

Therefore, the policies of these two cities are consistent with the medical insurance policies in other parts of the country after adjustment.

Insured people in Beijing don't have to rush to withdraw cash. The policy stipulates that the insured can withdraw the money that has been deposited in the personal account before September 1 2022. After September 1, the money will no longer be transferred to the medical insurance passbook, which is used exclusively for bookkeeping management and cannot be freely withdrawn. However, the medical insurance passbook can be used as an entrusted card-issuing bank account bound by insurance, and it still needs to be properly kept.

In addition, the money in the medical insurance card can be taken out under these circumstances:

If the insured person has settled abroad and his account has been cancelled, the social security center will refund the money in the personal account of endowment insurance and medical insurance to him at one time; If the insured dies unfortunately during the insurance period, all the money in the personal account of endowment insurance and medical insurance can be inherited by his beneficiary or legal heir; In addition, there is another situation, that is, cross-regional mobile employment, but the balance of medical insurance account can not be transferred out, you can take out the balance; The required information and processing procedures may vary from place to place. The specific system depends on local policies. Friends in need can call the social security hotline 12333 for consultation.

I would like to remind you that if any individual or organization claims to be able to withdraw the amount of social security personal account in advance, please don't be credulous and beware of being deceived.

Change 2, the amount of personal medical insurance account is reduced.

From September 1 day, 2022, all the basic medical insurance premiums paid by employees will be included in individual accounts, and the inclusion standard is 2% of the base of their own insurance contributions, and all the basic medical insurance premiums paid by employers will be included in the overall fund. Retirees' personal accounts continue to be transferred out of the overall fund according to the quota. The specific transfer criteria are: for those under 70 years old, the transfer criteria are 100 yuan/month, and for those over 70 years old (inclusive), the transfer criteria are 1 10 yuan/month.

This policy change mainly affects employees. 0.8%~2% of the medical insurance premium paid by the previous unit is transferred to the personal account and can be freely withdrawn. Now there is none, so the money recorded in the personal account of employee medical insurance will be reduced every month.

For example, a 35-year-old employee's salary is 1000 yuan. Before the policy adjustment, the personal account of medical insurance was credited monthly (2%+0.8%)× 10000 = 280 yuan, and after the policy adjustment, the medical insurance was credited monthly (2%× 10000 = 200 yuan). For employees aged 35-45, the salary is the same as 1 1,000 yuan. Before the policy adjustment, it is credited to the personal medical insurance account (2%+ 1%)× 10000 = 300 yuan, and after the policy adjustment, it is credited to 200 yuan. Employees over 45 are also paid 1000 yuan. Before the policy adjustment, the monthly personal medical insurance account (2%+2%)× 10000 = 400 yuan, and after the policy adjustment, it will be credited to 200 yuan. The change of this policy mainly affects on-the-job employees. In the past, 0.8%~2% of the medical insurance premium paid by the unit was transferred to the personal account, which can be freely withdrawn. Now it is gone. How can the insured inquire about personal account funds?

From September, 2022, from June/KLOC-0 to 5 every month, medical insurance agencies will complete the transfer of funds to individual accounts of employees and retirees according to the collection of medical insurance premiums.

After that, the insured can inquire about the transfer, settlement and use of personal account funds in the "I want to inquire" menu of Beijing medical insurance service platform, official website of Beijing Medical Insurance Bureau or the window of various district agencies.

Change 3. Personal account funds can be used by families.

From June 5438+February 1 2022, the personal account of the insured person can be used to pay the personal expenses incurred by registered family members in purchasing medicines, medical devices and medical consumables at designated medical institutions or retail pharmacies, and can also purchase supplementary medical insurance in Beijing for themselves and registered family members (at this stage, it refers to purchasing Beijing Pratt & Whitney Health Insurance).

In the past, personal medical insurance accounts could only be used for reimbursement of medical treatment. From June 65438+February 1 day, 2022, the surplus funds of Beijing employees' personal medical insurance over the years can be used by spouses, parents and children except for their own use. The enjoyment of medical insurance balance not only reduces the medical expenses of insured families, but also improves the utilization rate of medical insurance account balance.

Family members should meet two conditions when using the personal account of the insured:

First, "* * * economic personnel" also need to participate in Beijing's basic medical insurance (medical insurance personnel from other provinces and cities cannot use it); Second, it must be filed. After the insured person has used up the funds in his personal account, he can use the funds in his spouse, parents and children's accounts in the order of filing. Filing method:

From June 5438+00 to June 5438+05, 2022, the insured can use it from June 5438+02 to June 5438+0, 2022, after successful filing, through the service platform of Beijing Medical Insurance Company, the official website of Beijing Medical Insurance Bureau and the window of the agencies in various districts.

* * * Economic objects can modify the order of * * * economic accounts through the public service platform of medical insurance, official website of Beijing Medical Insurance Bureau or the window of agencies in various districts.

Change 4. Cancel the capping line of outpatient and emergency departments

Since June 65438+ 10/day, 2023, the maximum payment limit for medical insurance outpatient service for employees is no longer set, and the reimbursement ratio of less than 20,000 yuan remains unchanged; More than 20,000 yuan, employees will be reimbursed 60%; Retirees are reimbursed 80% (including unified supplementary medical insurance for retirees), and there is no upper limit.

The following figure shows the current reimbursement standard of medical insurance for urban workers in Beijing. The employee deductible line is 1.80 yuan, and the retiree deductible line is 1.30 yuan. Exceeding the deductible standard, the maximum annual reimbursement is 20,000 yuan:

This policy adjustment may have little impact on many young people. Because many young people are in good health, they can't go to the hospital several times a year and may not reach the deductible.

But it is very useful for some people with weak constitution, especially the elderly. Some patients need long-term medication and regular check-ups. The ceiling line of 20 thousand yuan for outpatient service is simply not enough, and it is easy to exceed it. Starting from next year, this part of medical expenses can also be reimbursed by medical insurance.

According to the official calculation, it is estimated that this change will benefit 1 0.7 million insured persons every year, reducing the burden of insured persons by about1100 million yuan.

Change five, reduce the deductible of employees' serious illness.

The minimum payment standard for serious illness medical insurance has been reduced from 39,525 yuan to 30,404 yuan, which is consistent with the minimum payment standard for serious illness insurance for urban and rural residents and has a lower threshold. Except the basic medical insurance for urban workers, 60% of the total medical expenses are within the range of 30,404-80,404 yuan, and 70% of the total expenses are reimbursed above 80,404 yuan.

It is estimated that it will benefit 35,000 insured persons every year and reduce the burden of insured persons by 654.38+0.2 billion yuan.