Recently, the topic of "Personal Medical Insurance Account Reform" has triggered heated discussions among netizens. Since April 2021, the State Council officially issued the "Guiding Opinions on Establishing and Improving the Financial Security Mechanism for Employee Basic Medical Insurance Outpatient Clinics".

They are all promoting implementation and there will be a transition period of about three years. By 2023, Guangzhou, Sichuan, Jiangsu, Heilongjiang and other places have officially launched the new medical insurance reform.

During the discussion, the most controversial point was that less money was transferred into personal medical insurance accounts every month, so criticisms such as "suffering losses" came one after another.

So what exactly has been changed in this medical insurance personal account reform?

The money in my personal account has decreased. Have I really suffered a loss?

Next, the editor will take you to learn more about it.

Why should medical insurance personal accounts be reformed?

Personal accounts have always existed in my country’s medical insurance system for more than 20 years. Many people do not understand why the interests of more than 300 million employees’ medical insurance participants are involved. This year, many regions directly implemented the New Deal reforms, even though they had already been implemented before. It took several years of preparation, but this reform still exceeded many people's expectations, especially because there were many opposing voices.

In fact, with the development of social economy and changes in personal medical needs, it is still necessary to establish a more complete medical insurance system, and this requires reform.

Data shows that nearly 40% of the cumulative balance of medical insurance funds is personal account balances. A large amount of fund balances are not used for practical purposes, which is obviously an urgent problem to be solved.

Therefore, the goal of this reform is to mobilize limited funds and use them on patients who really need them.

Why is there less money due to the reform of personal medical insurance accounts?

After this reform, because the basic medical insurance premiums paid by the unit will no longer be included in the personal accounts of active employees, the money recorded in the personal medical insurance accounts will be less. Many people feel that they are "suffering a loss".

In response to this, the official recently also officially responded: It does not mean that it will suffer a loss.

First of all, the reduced money will not be wasted, but will flow into the overall fund and be mainly used for outpatient financial security.

The previous personal medical insurance account was relatively limited in terms of outpatient coverage. If you were sick and wanted to be reimbursed, you could only be hospitalized. However, after the reform, the scope of reimbursement has been expanded. Now you basically can’t spend much money on outpatient treatment, which is equivalent to using personal insurance.

The reduced money transferred into the account increases the general outpatient benefits for insured employees. The final beneficiary is himself, and he will not suffer any loss.

Specifically, for example, the Xi'an Municipal Medical Security Bureau officially stated: "After the reform, not only did the previous benefits of insured persons not be affected, but general outpatient co-ordination benefits were also added. At the same time, the payment scope was further expanded, which can benefit a wider range of insured persons.

"In addition, some insured persons also said that they went to the outpatient clinic of Guangzhou First People's Hospital last year and had a lung CT, with a total medical cost of more than 480 yuan.

However, at that time, CT and other items were not included in the outpatient planning, so you had to pay the full amount out of pocket.

After this year's reform, I went to the hospital for a CT scan after I became healthy, and found that I only paid 140 yuan for the same project, and the overall fund paid 70%. Although less money was transferred to my personal account, I still enjoyed the benefits.

But it has become more.

Of course, all these changes require insured persons to go to outpatient clinics for medical treatment after falling ill. In the short term, everyone will still feel "suffering" because the money transferred into their personal accounts has really decreased.

What are the highlights after the reform?

Which group of people will benefit more?

All insured persons will generally benefit from this reform, especially those who are experiencing illness.

Many people think that the amount of money transferred into their personal medical insurance accounts has decreased, so they simply think that they have "suffered a loss". In fact, the decrease is far less than the increase.

This time to promote the reform of medical insurance personal accounts and establish an outpatient financial mechanism, the highlights mainly lie in the following four aspects: 1. Improved the use scope of medical insurance personal accounts. The use scope of medical insurance personal accounts has changed from individuals to family**

*Economy.

2. Retail pharmacies are included in outpatient coordination. Drugs purchased by retail pharmacies are also within the scope of reimbursement under outpatient coordination.

3. Pensions and medical insurance benefits are decoupled. Employee medical insurance can be applied for separately after retirement. There is no need to check whether you are insured for employee pension insurance and meet the retirement insurance conditions.

4. Improve the use efficiency of personal account funds to avoid accumulation of funds and reduce their use efficiency. At the same time, it also further strengthens the standardized supervision of medical insurance personal accounts.

Reform policies for medical insurance personal accounts in various places 1. Guangdong In January 2022, the General Office of the Guangdong Provincial People's Government issued the "Implementation Measures for the Outpatient Economic Security of the Employee Basic Medical Insurance", clearly establishing the outpatient financial guarantee of the Employee Basic Medical Insurance in Guangdong Province

Security system.

The "Measures" will be effective for 3 years.