New rules for medical insurance reimbursement in 2022

In 2022, the new medical insurance reimbursement regulations include reimbursement of outpatient expenses of insured persons according to the following provisions:

1. All outpatient clinics in designated villages, towns and street health centers of cooperative medical care are reimbursed by 25%, and the total outpatient compensation is the highest per person per year 150 yuan. Outpatient medical expenses of two or more designated medical institutions shall not be reimbursed;

2. When the participants reimburse medical expenses, they should hold their cooperative medical certificate, original medical bills, outpatient medical records and prescription reimbursement (the outpatient department implements the double prescription system);

3. Participants should complete the reimbursement settlement of the previous year within one month of the following year, and those who fail to complete the reimbursement will be regarded as giving up the reimbursement automatically. If the designated medical institution fails to handle the settlement in time, the compensation fee shall be borne by the designated medical institution.

Medical insurance generally refers to basic medical insurance, which is a social insurance system established to compensate workers for economic losses caused by disease risks. The medical insurance fund is established through the contributions of employers and individuals. After the insured person has medical expenses, the medical insurance institution will give certain economic compensation. The establishment and implementation of the basic medical insurance system has gathered the economic strength of units and social members. With the government's funding, sick social members can get necessary material help from the society, reduce the burden of medical expenses, and prevent sick social members from "poverty due to illness".

legal ground

People's Republic of China (PRC) social insurance law

Article 7 The administrative department of social insurance in the State Council is responsible for the management of social insurance throughout the country, and other relevant departments in the State Council are responsible for the relevant social insurance work within their respective functions and duties. The social insurance administrative department of the local people's government at or above the county level shall be responsible for the social insurance management within its administrative area, and other relevant departments of the local people's government at or above the county level shall be responsible for the relevant social insurance work within their respective functions and duties. Tenth employees should participate in the basic old-age insurance, the basic old-age insurance premiums paid by the employer and employees. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic old-age insurance in the employer and other flexible employees can participate in the basic old-age insurance, and individuals pay the basic old-age insurance premium. The measures for the endowment insurance of civil servants and staff managed by reference to the Civil Service Law shall be formulated by the State Council.