Xiamen 2023 medical and social security regardless of foreign hukou.

Starting from 65438+2023 10/month, the maximum payment limit of serious illness insurance for employees and residents in Xiamen will be raised within one year. After the basic medical insurance is superimposed, the comprehensive protection level will reach 6.5438+0.2 million yuan and 600,000 yuan respectively, further improving the protection level of serious illness insurance.

Recently, in order to implement the unified deployment of the state and Fujian Province, the Xiamen Municipal Government issued the Detailed Rules for the Implementation of Medical Insurance for Employees in Xiamen and the Detailed Rules for the Implementation of Medical Insurance for Urban and Rural Residents in Xiamen (hereinafter referred to as the Detailed Rules). It is reported that the "Detailed Rules" will be officially implemented on June 65438+1 October1day, 2023, which not only unifies the medical insurance policy of migrant workers and employees in this city, simplifies the reimbursement process for outpatient services, but also enhances the economic security function of outpatient services.

According to the "Detailed Rules", starting from June 5438+ 10, 2023, Xiamen will no longer distinguish between migrant workers and employees in this city, and realize equal pay and equal treatment. At the same time, relax the household registration restrictions for flexible employees to participate in employee medical insurance. Non-local registered employees within the legal working age, as long as they hold a valid residence permit in this city, must participate in employee medical insurance in Xiamen as flexible employees. The contribution rate is 9.5%, and it enjoys the same medical insurance benefits as employees in this city, effectively protecting the rights and interests of workers in new employment forms. At the same time, from June 5438+0 to February 1 in 2023, the payment rate will be reduced by 1 percentage point, that is, 8.5% will be paid to reduce the burden of flexible employees.

In recent years, with the development of economy and society, the proportion of migrant workers in Xiamen is increasing, which has played an important role in the construction of special economic zones. In order to further protect the rights and interests of migrant workers, the Detailed Rules unified the medical insurance policies of migrant workers and workers in this Municipality, and adjusted the unit contribution rate of migrant workers' medical insurance to be consistent with that of workers in this Municipality, that is, all employees on the job implemented a unified unit contribution rate of 7.5% and individual contribution rate of 2% in the whole province, enjoying the same medical insurance benefits. From June 5438+0 to February 1 in 2023, the unit contribution rate decreased by 1 percentage point, that is, 6.5% was paid.

On this basis, the "Rules" strengthen the economic security function of the overall fund by adjusting the distribution of individual accounts of employees' medical insurance, standardizing individual accounts, and coordinating the policies of primary clinics. According to reports, this reform strictly implements the requirements of the state and Fujian Province on adjusting the accounting method of personal accounts and enhancing the economic security function of outpatient services. The specific adjustments are as follows: all the individual contributions of on-the-job employees are included in the personal account unchanged, and all the unit contributions are included in the overall fund; According to the regulations, the standard of individual accounts for retirees is set at 2.5% of the average basic pension level in the year when the reform was implemented, that is, the quota is 1 10 yuan per person per month. The personal account is adjusted from the original one-time annual pre-allocation to monthly allocation.

According to the staff of Xiamen Medical Insurance Bureau, compared with the health account policy issued on 20 12, the "Detailed Rules" incorporated the functions of health accounts into personal accounts, and the insured can also pay the personal medical expenses and residents' medical insurance expenses incurred by the insured family members in Fujian Province by establishing the family account. After this adjustment, personal accounts are used more widely and more efficiently.

In addition, the "Detailed Rules" also simplified the outpatient reimbursement process, increased the maximum payment limit of serious illness insurance, and gave preferential policies to special relief objects, further improving the comprehensive security level of insured persons and keeping the bottom line of people's livelihood. Take the outpatient reimbursement process as an example. In the past, the outpatient medical expenses reimbursement was implemented in a "three-stage" mode, that is, the insured must use up the funds in his personal account before he can enter the overall reimbursement. Nowadays, the "Rules" simplify the outpatient co-ordination reimbursement model to "two stages", that is, the insured can enter the co-ordination reimbursement without running out of personal account funds after reaching the threshold. Personal account funds can be used to offset the out-of-pocket medical expenses above the outpatient qifubiaozhun. By simplifying the outpatient reimbursement process, the number of people enjoying the overall fund has been expanded, and the outpatient security level of the insured has been improved.