It is understood that in 2023, the fund-raising for residents' medical insurance participation will be no less than 960 yuan per person. Among them, the financial subsidy is not less than 6 10 yuan/person, and the individual payment standard is 350 yuan/person.
In 2023, the individual payment of residents' medical insurance will be mainly centralized payment, supplemented by sporadic payment. The collection period is divided into centralized collection period and sporadic collection period.
Centralized collection period is:
2022 1 October 20th to March 30th, 20231.
The sporadic collection period is:
1. Ordinary people from April 2023 1 day to 2023 1 October 31day.
2. Specific groups (ex-servicemen and unemployed spouses, workers transferred to residents for medical insurance) and people with special difficulties: April 2023 1 to February 3, 20231.
3. Newborns: from April 1 day to March 3 1 day, in which they are only collected from June 1 day to March 3 1 day to June 12, 2023.
During the centralized collection period, ordinary people pay the insurance premium according to the standard of 350 yuan/person; The fixed subsidy object only needs to pay part of the expenses that should be paid by the individual after the government subsidy; Individuals who receive full funding do not have to pay. Those who pay insurance premiums during the centralized collection period will enjoy medical insurance benefits for residents from June 65438+1 October1day, 2023.
During the sporadic collection period, ordinary people pay insurance premiums according to the 960 yuan/person standard, and enjoy residents' medical insurance benefits after 60 days (excluding 60 days) from the date of payment. People with special difficulties pay insurance premiums according to the standards of 350 yuan/China, and enjoy residents' medical insurance benefits from the date of payment.
Unemployed spouses in the army in the year when soldiers retired from active service and in the year when soldiers retired from active service participated in residents' medical insurance, and the payment was not limited by the number of years of centralized collection. Those who pay the insurance premium according to the 350 yuan/person standard will enjoy the medical insurance benefits for residents from June 65438+ 10/day, 2023; Sporadic collection period payment, enjoy residents' medical insurance benefits from the date of payment.
A 90-day dynamic policy is implemented in the year of birth. Newborns who pay insurance premiums in sporadic collection period shall pay insurance premiums according to 350 yuan/person within 90 days (including 90 days) from the date of birth. Those who use household registration information to pay insurance premiums will enjoy medical insurance benefits for residents from the date of birth. For newborns who have not used household registration information to pay insurance premiums, the medical expenses incurred since the date of birth can be included in the medical insurance reimbursement after the guardian improves his identity information; If the insurance premium is paid after 90 days (excluding 90 days) from the date of birth, the insurance premium shall be paid according to 960 yuan/person, and residents shall enjoy medical insurance benefits after 60 days (excluding 60 days) from the date of payment.
Workers' medical insurance will be transferred to residents' medical insurance personnel, and a 90-day dynamic insurance policy will be implemented. Those who participate in employee medical insurance can participate in residents' medical insurance within 90 days (including 90 days) after the suspension of employee medical insurance, pay insurance premiums according to the standard of 350 yuan/person, and enjoy residents' medical insurance benefits from the date of payment; If the payment is over 90 days (excluding 90 days), the insurance premium shall be paid according to the standard of 960 yuan/person, and residents shall enjoy medical insurance benefits after 60 days (excluding 60 days) from the date of payment.
Legal basis:
Notice on doing a good job in the payment of basic medical insurance for urban and rural residents in 2023
I. Work objectives
Adhere to the people-centered development idea, aim at universal coverage and insurance according to law, thoroughly implement the universal insurance plan, optimize the insurance payment service, improve the quality of insurance information, and keep the participation rate of basic medical insurance for permanent residents (including residents' medical insurance and employees' medical insurance) above 95% continuously, so as to ensure that the monitored objects (including unstable poverty-stricken households, marginal poverty-prone households and households with sudden serious difficulties) will not return to poverty. Hereinafter referred to as the "monitoring object"), the minimum living security object, the marginal family members of the minimum living security, the destitute, the severely disabled, orphans, the children who are actually left without support, and the stable poverty-stricken population are all included in the coverage of the basic medical insurance, achieving full coverage and full payment.
Second, the insurance payment policy
(a) clear the scope of insurance. The medical insurance system for urban and rural residents covers all urban and rural residents except those who should be insured by the basic medical insurance for employees, including rural residents, urban non-employed residents, students at school, and permanent residents who have obtained residence permits for overall planning areas.
(two) unified financial subsidy standards. In 2022, the financial subsidy standard for residents' medical insurance will be 6 10 yuan/person. In 2023, the financial subsidy standard for residents' medical insurance will be implemented in accordance with state regulations. Among them, the medical insurance subsidy funds for urban and rural residents shall be shared by the provincial, municipal (state) and county (urban) governments, and shall be implemented in accordance with the Notice of the General Office of the People's Government of Hunan Province on Printing and Distributing the Implementation Plan for the Division of Financial Affairs and Expenditure Responsibilities of Provinces, Cities and Counties in the Medical and Health Field (No.40 of Xiangfu Office [2019]). City (state), county (urban) financial departments should arrange the budget in full according to the prescribed standards and timely allocate subsidy funds. City (state) and county (city) financial subsidies must be in place before the end of July 2023. If it is not in place in time and in full according to the regulations, the provincial finance will deduct the central and provincial financial subsidy funds accordingly, and the deduction will be supplemented by the municipal (state) and county (urban) finance.
(3) unify individual payment standards. According to the Notice of State Taxation Administration of The People's Republic of China Ministry of Finance and National Health Insurance Bureau on Doing a Good Job in Basic Medical Security for Urban and Rural Residents in 2022 (No.20 [2022] of Medical Insurance), the individual payment standard of medical insurance for residents will reach 350 yuan per person per year in 2022. In order to adapt to the growth of medical expenses and the improvement of basic medical needs, and protect the medical insurance rights and interests of the insured, combined with the actual situation in our province, through research, the individual payment standard of medical insurance for residents in the whole province will be unified as 350 yuan/person in 2023.
(4) Fully implement the subsidy policy for people in need. The poverty-stricken population (children with severe disabilities, orphans and no actual dependents) who participate in the residents' medical insurance will be fully funded, and 50% will be funded for the low-income objects, guardianship objects and marginal family members. Cities and states may, according to the actual situation, give appropriate subsidies to the individual contributions of difficult retired soldiers, difficult children and other difficult groups who participate in residents' medical insurance, and the specific standards shall be determined by the local people's government. Encourage qualified towns, streets, collectives, units or other social and economic organizations to support or subsidize urban and rural residents to pay insurance premiums.
During the period of centralized insurance payment, the newly added difficult objects of relevant departments can enjoy the insurance subsidy policy in 2023. During the period of centralized insurance payment, the same payment and compensation will be implemented for the difficult objects, and individuals only need to pay part of the funds payable according to the regulations. People with difficulties who have participated in residents' medical insurance in different places can enjoy the insurance subsidy policy in their household registration.
(five) unified insurance payment time. Urban and rural residents pay the basic medical insurance premium once a year. In principle, the payment period of residents' medical insurance in 2023 is from September 1 day to February 3 1 day. If the overall planning area fails to reach the required participation rate as scheduled, the payment period for centralized participation can be appropriately extended to February 28, 2023. In addition to the special circumstances that have been clearly defined, those who are not insured during the centralized insurance payment period shall not be insured and enjoy medical insurance benefits in principle.
Within 90 days after the birth of a newborn, the guardian shall register the newborn with his real name with the residence booklet or residence permit, use the residence booklet or medical birth certificate, and go through the registration and payment procedures according to the regulations of the overall planning area. The compliant medical expenses incurred since the date of birth can be included in the medical insurance reimbursement. Children received by children's welfare institutions, who are not insured after verification, can pay with the insurance and enjoy medical insurance benefits from the date of entering the children's welfare institutions. Employees whose medical insurance coverage is interrupted due to the termination of labor relations can participate in residents' medical insurance within 90 days from the date of interruption and enjoy medical insurance benefits from the date of interruption. Employees in new forms of employment will be insured for the first time at their place of residence with their residence permits, and retired soldiers, released prisoners and fresh college graduates who have not been employed in time will enjoy medical insurance benefits from the date of insurance payment. Unstable poor households, marginal poor households, families with sudden serious difficulties, low-income households, members of marginal families with minimum living security, destitute people, severely disabled people, orphans, children without support, and stable poor people, who are not insured for objective reasons during the period of centralized insurance payment, can enjoy medical insurance benefits from the date of insurance payment. The above special circumstances are paid according to the individual payment standard of residents' medical insurance.
Due to objective reasons such as household registration change or other special circumstances (specifically, those newly moved into the household registration in that year, newborns failed to pay the insurance premium within 90 days, the coverage of medical insurance was cut off within 90 days, and cities and counties failed to go through the insurance payment procedures within the specified time in the overall planning area), they can pay the basic medical insurance premium in full in one lump sum according to the annual residents' medical insurance financing standards (including individual contributions and financial subsidies), and enjoy medical insurance benefits from the next month of payment.
(six) unified insurance payment methods. According to the principle of territorial management, urban and rural residents (including primary and secondary school students and preschool children) take the family as the unit to participate in the insurance at the domicile or permanent residence; College students (including freshmen) take the school as the unit to participate in the overall insurance at the school location, and the school collects and pays the residents' medical insurance expenses, and uniformly handles the insurance registration procedures. Newly enrolled college students are insured at the place where the school is located, and may not be insured repeatedly at the original domicile. Urban residents who have not participated in employee medical insurance (including permanent residents who have obtained residence permits) participate in resident medical insurance in the community.
Third, the job requirements
(1) Strengthen organizational leadership. Cities, prefectures, counties and cities should, in accordance with the requirements of "Implementation Opinions of Hunan Province on Further Deepening the Reform of Tax Collection and Management" (Xiang Ban Fa [202 1] 14) on "establishing a social insurance fee collection system for urban and rural residents with unified government organization, multi-party cooperation, centralized collection or entrusted collection", make overall plans for the collection of residents' medical insurance fees, and improve the work coordination and guarantee mechanism. All localities should pay close attention to the study and formulation of the Work Plan for the Collection and Payment of Medical Insurance Fees for Urban and Rural Residents in 2023, clarify the objectives of insurance payment and the subsidy standards for people in need, and clarify the work responsibilities and tasks of relevant departments such as medical insurance, taxation, education, civil affairs, finance, rural revitalization, disabled persons' federations and residents of towns, streets, villages and community organizations. Extensively carry out mobilization and deployment of insurance payment, establish assessment, incentive and supervision mechanisms, and ensure the completion of the target and task of medical insurance payment for urban and rural residents in 2023 as scheduled.
(2) Strengthen departmental cooperation. The tax authorities should fully perform the duties of collecting medical insurance premiums for urban and rural residents and increase the intensity of collection. Constantly optimize the information system of residents' medical insurance fee collection, and do a good job in maintaining the collection policy; Broaden payment channels and optimize payment services.
The medical insurance department should closely cooperate with the tax department to do a good job in the payment of insurance for urban and rural residents, clarify the subsidy standards for all kinds of people with difficulties, and implement the subsidy funds for people with difficulties in conjunction with the financial department. Before the centralized collection and payment work is carried out, it is necessary to accurately identify the identities of all kinds of people with difficulties in the medical insurance information system, establish a ledger of insurance and funding for people with difficulties, and feed back the approved list of people with difficulties, the amount of insurance and the amount of individual contributions to the tax authorities at the same level, and the tax authorities will collect individual contributions from people with difficulties according to the current special identification of payers. In the medical insurance information system, accurately record the insured amount and individual paid-in amount of people in difficulty.
The education department is responsible for dispatching full-time colleges and universities (including private schools) to participate in the medical insurance for urban and rural residents, providing the medical insurance and tax departments with the list of colleges and universities that should be insured, refusing to cooperate with the schools that organize students to participate in the overall medical insurance for urban and rural residents at the school location, and urging the medical insurance and tax departments to make rectification. Responsible for urging colleges and universities to provide an accurate list of poor students who can enjoy the insurance subsidy policy according to the policy. Responsible for urging primary and secondary schools and kindergartens to cooperate with the mobilization of insurance payment, and provide the list of personnel to the medical insurance and tax departments for comparison of insurance information.
The civil affairs department is responsible for verifying the list of social assistance objects such as poor people, low-income households, marginal family members with minimum living guarantee, orphans and children without actual dependents, and feeding back the dynamic adjustment information to the medical insurance and tax departments on a monthly basis to assist in the related work of insurance payment.
The financial department is responsible for, in conjunction with the medical insurance and other relevant departments, after the end of the centralized insurance payment period, timely transfer the insured funds of the needy people into the financial accounts of the medical insurance fund.
The rural revitalization department is responsible for verifying the monitoring objects and stabilizing the list of people out of poverty, feeding back the dynamic adjustment information of the monitoring objects to the medical insurance and tax departments at the same level on a monthly basis, and assisting the medical insurance and tax departments to urge them to handle the insurance payment procedures.
Disabled Persons' Federation is responsible for providing the list of severely disabled persons, and feeding back the dynamic adjustment information to the medical insurance and tax departments on a monthly basis to assist in the work related to insurance payment.
(3) Optimize payment services. Establish a unified and efficient medical insurance fee collection management system. Where conditions permit, we can explore the personal account of employee medical insurance for the individual contributions of spouses, parents and children to participate in residents' medical insurance. According to the requirements of full coverage of basic medical insurance, all localities should continue to establish a "tax administrator+social security Commissioner+coordinator" grid management mechanism with townships as the fulcrum and village groups as the end. During the period of centralized insurance payment, all localities should strengthen analysis and judgment according to the progress of insurance payment, and implement accurate promotion for uninsured personnel. It is necessary to vigorously promote "non-contact" payment methods such as Hunan Tax Social Security APP, WeChat applet and mobile banking.
(4) Strengthen publicity and guidance. It is necessary to compact work responsibilities, ensure that all policies and measures for medical security for urban and rural residents are effective, and continue to promote security and improve people's livelihood. It is necessary to explore innovative propaganda methods, further intensify policy propaganda, popularize the concepts of mutual assistance, responsibility and enjoyment of medical insurance, enhance the people's awareness of insurance payment, and reasonably guide social expectations.
This notice is valid from September 1 day, 2022 to February 3 1 day, 2023. The Notice on Doing a Good Job in the Payment of Basic Medical Insurance for Urban and Rural Residents in 2022 (Xiang Medical Insurance [20265438] No.31) shall be abolished at the same time.