For example, in Anhui Province, the new regulations include 15 dental medical services such as tooth desensitization treatment, fluoride caries prevention treatment, scaling and local oral irrigation into the scope of medical insurance payment in Anhui Province. Implemented on July 1 day, 2022. At present, the number of oral medical services included in medical insurance reimbursement in Anhui Province will increase to 293, and the next step will gradually reduce the threshold for dental medical expenses of insured persons.
With the continuous development of China's social security system, an important reference standard for many people when choosing a job is whether to buy social security at the right time. Social security has become an important indicator to protect the rights and interests of residents. Pay social security on time, you can get social insurance benefits such as pension in the future, so it is also very important to pay social security.
From July 1 2022, the payment base and rate of the basic medical insurance for employees in our city (hereinafter referred to as "employee medical insurance") will be adjusted as follows:
(1) payment base
1. In-service personnel
The payment base of employees and flexible employees in our city is adjusted as follows:
note:
(1) "Last year's social wage" refers to "the average monthly wage of employees in the whole city last year", which was 5,825 yuan in June 2022;
(2) "Last year's average monthly salary of employees" refers to "the average salary of employees in non-private units in cities and towns and the average salary of employees in private units in cities and towns in the previous year", which is 6,397 yuan after July 2022, and the data is published uniformly at the beginning of each year.
(three) the wages of flexible employees shall be truthfully declared by myself on a monthly basis.
2. Retirees
The insured who participates in employee medical insurance has reached the statutory retirement age, but has not reached the payment period stipulated by our city, and the payment base is adjusted accordingly with the change of employee medical insurance base:
(1) If one-time payment period is selected, the payment base will be adjusted to the average monthly salary of employees in the previous year when one-time payment is made;
(2) If you choose to continue to pay monthly, the payment base will be adjusted to the average monthly salary of employees in the previous year;
(3) if you choose to continue to pay monthly fees and continue to be employed by the original unit, your salary income will be the base.
(2) Payment rate
In view of the adjustment of the payment base, the employee medical insurance payment rate is adjusted simultaneously. The comparison of the actual payment rate before and after adjustment is as follows:
Note: The payment standard of basic medical insurance for urban and rural residents (hereinafter referred to as "residents' medical insurance") remains unchanged, and it will continue to be levied at 2. 1% of the average salary of the previous year, of which the personal burden is 0.9% and the financial burden is 1.2%.
02. Adjustment of starting and ending time of treatment and annual maximum payment limit.
From July 1 day, 2022, the effective time and corresponding annual quota of basic medical insurance (including employee medical insurance and resident medical insurance, hereinafter referred to as "basic insurance") in our city will be adjusted as follows:
(a) Start and end time of treatment
1. New insured: If the insured pays the basic insurance premium in full and on time, they will enjoy basic insurance benefits and medical insurance for major diseases (hereinafter referred to as "critical illness insurance") from the month after the payment, and stop the treatment from the month after the payment is stopped.
2. Enjoy the treatment of interruption of payment (including suspension of insurance): if the insured person has interrupted payment for less than 3 months (inclusive), he can go through the formalities of supplementary basic insurance according to the regulations, which is regarded as continuous insurance, and there is no waiting period for treatment after payment; Interrupted for more than 3 months, calculated according to the provisions of the new insured.
(2) Annual maximum payment limit
With the adjustment of the start and end time of treatment enjoyment, the original continuous participation limit enjoyment period of "dissatisfaction 1 year for two months" is adjusted to "dissatisfaction 1 year for enjoyment 1 month".
Legal basis:
People's Republic of China (PRC) social insurance law
Article 26
The basic medical insurance for employees, the new rural cooperative medical system and the basic medical insurance for urban residents shall be implemented in accordance with state regulations.
Article 27
Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.
Article 28
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.
The administrative department of social insurance and the administrative department of health shall establish a settlement system for medical expenses in different places to facilitate the insured to enjoy the basic medical insurance benefits.