The news of the new medical insurance policy for retirees in 2017 has just come out and the individual contribution rate has been raised again.
In recent years, due to the combined effects of the three factors of substantial increase in medical expenses, slowdown in the growth rate of medical insurance financing and the aging of the population, medical insurance funds are facing unprecedented revenue and expenditure pressure, and the cumulative balances in many regions have not reached the targets set by the Ministry of Human Resources and Social Security.
Prepare for "6 to 9 months" requirement.
Data show that over the past six years, the growth rate of per capita financial subsidies for urban residents' basic medical insurance has been higher than the per capita personal payment growth. As a result, the proportion of financial subsidies in the total per capita financing has increased from 60.8% in 2009 to 2014.
79.3%, and the ratio of financial subsidies to personal payments is close to 4:1. In 2015, the government subsidy standard for urban residents’ medical insurance is 380 yuan per person, and the personal payment is no less than 120 yuan per person.
Jin Weigang, director of the Social Security Research Institute of the Ministry of Human Resources and Social Security, believes that the current financing ratio of resident medical insurance is unreasonable, and the growth of financing level mainly depends on finance. Financial subsidies account for an excessively large proportion of the entire financing ratio, and individual contributions account for a small proportion.
This will lead to increasing pressure on future medical insurance funds.
In order to make up for the gap in medical insurance, Finance Minister Lou Jiwei once wrote an article in Qiushi magazine that deepening the reform of the social security system, accelerating the reform of the pension insurance system, focusing on improving personal accounts and adhering to actuarial balance, and establishing a system that pays more and gets more and pays more for a long time.
With more incentive and restraint mechanisms and a more transparent and easy-to-understand collection and payment system, under this premise, we can achieve national coordination of employee basic pensions, allocate state-owned capital to enrich social security funds, accelerate the development of supplementary pension insurance, establish a reasonable growth mechanism for basic pensions, and
Closely linked to payment contributions.
Reform the medical insurance system, establish a reasonable sharing and sustainable medical insurance financing mechanism, study and implement employee medical insurance retiree payment policies, establish a medical insurance benefit adjustment mechanism that is consistent with the level of financing, fully implement the critical illness insurance system for urban and rural residents, and reform medical insurance payment methods,
Integrate the basic medical insurance system, promote the de-administrative reform of public hospitals, combine with new urbanization, run rural and village hospitals well, and truly establish an orderly and hierarchical diagnosis and treatment pattern.
Among them, the study and implementation of the retiree payment policy for employee medical insurance has attracted great attention.
According to estimates, if retirees pay for medical insurance, they will use the average pension as the base. Based on this calculation, according to 2015 standards, the average payment for retirees may be about 100 yuan per person per month.
In addition, many local governments have explored and encouraged residents to buy commercial insurance.
In December last year, the Ministry of Finance, the State Administration of Taxation, and the China Insurance Regulatory Commission issued a notice to implement pilot commercial health insurance personal income tax policies in 31 cities including Beijing and Shijiazhuang City, Hebei Province. The expenditures of individuals in the pilot areas purchasing health insurance products that meet the regulations will be based on
The annual limit of 2,400 yuan is deducted before personal income tax.
How much does it cost to pay for medical insurance in 2017? 1. The main purpose of medical insurance card 1. The main purpose of medical insurance is to pay for outpatient treatment.
2. Medical insurance has other uses. You can use the money to buy medicines (over-the-counter drugs), medical equipment, thermometers, blood pressure monitors and other auxiliary examination equipment at designated pharmacies.
2. How to use the money in the medical insurance card account. As we all know, employee medical insurance is generally divided into individual accounts and collective accounts. How to use the two? Personal accounts can pay for the following expenses: 1. Drug purchases at designated retail pharmacies, outpatient services
, emergency medical expenses; 2. used to purchase commercial insurance, accident insurance, etc.; 3. medical expenses below the basic medical insurance co-ordinating fund threshold; 4. exceeding the basic medical insurance co-ordination fund threshold, the individual shall bear the proportion
Fees payable; 5. If the personal account is insufficient to pay, the fee shall be paid by myself.
The overall account mainly pays for the following expenses: 1. Medical expenses for hospitalization; 2. Outpatient medical expenses for radiotherapy for malignant tumors, renal dialysis, and anti-rejection drugs after kidney transplantation; 3. Patients admitted to hospital after emergency rescue, and other expenses.
Medical expenses for the seven days before hospitalization will be observed.
3. Scope of medical insurance reimbursement 1. The reimbursement of the medical insurance card is limited to medical expenses above hospitalization caused by diseases and some accidents in designated hospitals.
The reimbursement formula is: (total cost-threshold fee-self-pay-overexpense)*(75+age*0.2)%. Under normal circumstances, the actual reimbursement ratio ranges from 20 to 60%.
Self-paid drugs are not reimbursed, Class B drugs are reimbursed 80%, bed fees are subject to a limit, and some examination fees and diagnosis and treatment fees according to regulations cannot be reimbursed.
2. The reimbursement amount of the medical insurance card is four times the average salary of local social workers (the cumulative value within one year).
3. The money in the medical insurance card can be used to buy medicines in designated pharmacies and pay outpatient and emergency expenses, but it does not fall into the scope of reimbursement, because the money in the medical insurance card is the money in the personal medical insurance account.
4. The critical illness insurance will reimburse the insured person for his or her personal responsibility incurred in designated medical institutions of the city after suffering a serious illness and in compliance with the provisions of the city's medical insurance. This will be included in the payment scope of the residents' critical illness insurance, and 50% will be reimbursed by the critical illness insurance funds.