Reform the calculation method of personal account;
According to the unified account mode (unit contribution 10%, individual contribution 2%), the individual account of employee medical insurance is included in the employee medical insurance premium paid by individuals, and the inclusion standard is 2% of the base of my insured contribution, and all the unit contributions are included in the employee medical insurance pooling fund; According to the unified account mode, the individual accounts of retirees will continue to be allocated by the employee medical insurance pooling fund according to the quota. The specific criteria are 40 yuan under 70 years old, 50 yuan over 70 years old, and 60 yuan, an old worker before the founding of the People's Republic of China.
Standardize the scope of personal accounts:
From June 5438+1 October1day, 2022, there will be no capital injection management for employees' personal medical insurance accounts. It is mainly used to pay the expenses borne by the insured himself within the policy scope of designated medical institutions or designated retail pharmacies, and can also be used to pay the expenses incurred by individuals in designated medical institutions or designated retail pharmacies. From July 1 2022, it can also be used to pay the expenses incurred by the insured in purchasing medical devices and medical consumables in designated retail pharmacies, the expenses incurred by their spouses, parents and children in designated medical institutions in this city, the expenses for purchasing drugs, medical devices and medical consumables in designated retail pharmacies, and the personal contributions for participating in the medical insurance and long-term care insurance for residents in this city; Spouses, parents and children who are insured in other places may apply according to the above provisions. Personal accounts shall not be used for public health expenses, physical fitness or health care consumption and other expenses that are not covered by the basic medical insurance.
From July 1 day, 2022, the personal account funds of employees participating in basic medical insurance can be used to pay for themselves, their spouses, parents and children, as well as to participate in the individual contributions of customized commercial health insurance in cities in line with the Guiding Opinions of Tianjin Banking Insurance Bureau of Municipal Medical Insurance Bureau on Supporting and Promoting the Development of Commercial Health Insurance (No.87 issued by Tianjin Medical Insurance Bureau [202/KLOC-0]).