First, the funds in individual employee medical insurance accounts have decreased.
In August 2020, the National Medical Insurance Administration issued the "Guiding Opinions on Establishing and Improving the Financial Security Mechanism for Outpatient Basic Medical Insurance for Employees (Draft for Comments)", which improved the method of counting employees' personal accounts. The original medical insurance personal accounts except In addition to 2% of personal contributions, part of corporate contributions is also transferred to personal accounts. However, now all corporate contributions will be transferred to the overall fund. This move may seem like a personal loss, but in fact it is. It better protects people's medical treatment, because the reduced personal account funds will be mainly used for outpatient financial security and improve outpatient medical reimbursement benefits.
Second, the scope of use of employee medical insurance personal accounts has been expanded.
In the past, a personal medical insurance account could only be used by the person himself and could not be lent to others. However, this draft proposes that the individual’s medical insurance card can also be used by his spouse, parents and children. He can go to pharmacies to buy medicines and medical consumables, such as Rehabilitation equipment, health care equipment, etc. expand the scope of use of medical insurance cards, which is more conducive to optimizing the allocation of medical resources and making people's lives more convenient.
Third, insurance information across the country is interconnected
In the past, our medical insurance information has not been networked nationwide. Once the payment city is changed, all insurance payment records may not be found. In September 2020, the "Guiding Opinions on Strengthening and Improving the Basic Medical Insurance Participation Work" proposed , starting from 2021, the national insurance information will be interconnected, and the national unified medical insurance information platform will be used to verify the insurance payment status of the insured. It not only improves the statistical quality of insurance participation information, but also effectively controls the phenomenon of repeated insurance participation and cross-system insurance participation, effectively reducing the waste of national social security funds.
Fourth, medical insurance payments will be discontinued, and insured persons will have benefits and a waiting period.
In the past, once the medical insurance payments were stopped, they would not be able to enjoy the medical insurance reimbursement benefits from the next month. This is a great pity for those who have stopped paying the medical insurance due to changing jobs or some force majeure factors. However, the "Guidance Opinions" clearly states that for those who have been insured continuously for 2 years or more, the payment suspension shall not exceed 3 months, and they can enjoy the medical insurance benefits seamlessly after renewal. However, for those who have been insured for more than 3 months, each region can Depending on your own situation, you can set a waiting period of no more than 6 months to enjoy benefits. If you fail to pay after the period, the medical insurance relationship will be suspended. This measure is very user-friendly and guarantees the medical insurance benefits of the insured, and effectively improves the continuity of medical insurance payments. In short, it is more beneficial for people to seek medical treatment.
Fifth, outpatient expenses can be settled directly across provinces
With the continuous strengthening of outpatient coordination, while ensuring that people enjoy medical reimbursement benefits, the state is also constantly improving the medical insurance reimbursement process. It is expected that by the end of this year, our country will achieve cross-provincial settlement of outpatient expenses, and people from other places can directly use social security cards to settle when they see a doctor. For expenses, you don’t need to advance money yourself, and then return to the insured place with a bunch of supporting documents to apply for reimbursement. This eliminates the need for complicated reimbursement procedures, which greatly saves time and costs.
It is inevitable to be sick and hospitalized in life, and every reform of the medical insurance policy is constantly improving the social security system and making it more convenient for the people. More people will benefit from it in the future.