The medical insurance for laid-off workers is stipulated by the state, so you must know the relevant policies and your own rights and interests.

all retired, laid-off and resigned employees of state organs, organizations, institutions, enterprises owned by the whole people and county-level collective-owned enterprises who participate in social insurance are entitled to medical insurance benefits (the medical expenses of laid-off employees' families are not reimbursed if they are not included in the overall plan).

Article 27 of the Social Insurance Law of the People's Republic of China stipulates: "Individuals who have participated in the basic medical insurance for employees will not pay the basic medical insurance premium after being laid off, and enjoy the basic medical insurance benefits according to the national regulations, if the accumulated payment reaches the fixed number of years stipulated by the state when they reach the legal laid-off age; If it is not reached, it can be paid to the prescribed period of time. " The core spirit of this provision is: "After being laid off, employees will no longer pay the basic medical insurance premium and enjoy the basic medical insurance benefits in accordance with state regulations;" The flexible precondition of this provision is: "the cumulative payment has reached the national fixed number of years". It is precisely because the country has no unified regulations that all localities have their own needs and do their own things, which infringes on the legitimate rights and interests of laid-off workers' medical insurance for social vulnerable groups.

It is not easy to solve the problem of medical insurance for laid-off workers according to law, and the following measures are suggested:

First, it is suggested that the National People's Congress instruct the Supreme People's Court to issue and implement the relevant judicial interpretation of the Social Insurance Law of the People's Republic of China as soon as possible, clearly stipulate the payment period of medical insurance for laid-off workers (including the deemed payment period of 2 years), and safeguard the legitimate rights and interests of medical insurance for laid-off workers in the form of legal system.

Second, it is suggested that the State Council instruct Ministry of Human Resources and Social Security to formulate and implement the implementation opinions of the Social Insurance Law of the People's Republic of China as soon as possible, and clearly stipulate that "employees who have paid accumulated contributions for 2 years (including deemed payment years) when they are laid off will not pay the basic medical insurance premium after they are laid off, but enjoy the basic medical insurance benefits according to state regulations."

Third, it is suggested that the State Council instruct the Fujian Provincial Government to cancel the "Detailed Rules for the Implementation of the Basic Medical Insurance for Flexible Employees at the Same Level in Fujian Province" formulated by the Provincial Labor and Social Security Department, which stipulates that laid-off workers should "actually pay for 1 years" in addition to the payment period (including deemed payment period) of 25 years, correct their wrong practices, and be fair to laid-off workers.

We laid-off workers from state-owned enterprises made contributions to the country when they were on duty, and made contributions to reform when they were laid off. How can we be asked to make sacrifices after being laid off now? ! I hope the country will turn the "happiness index" of laid-off workers from our laid-off state-owned enterprises from ideal to reality as soon as possible!

The laid-off pension fund management committee has a medical management office. Before the establishment of the institution, the social insurance company shall temporarily perform its duties; Each township, town and field shall set up a medical insurance management team with the trinity of party committees and governments, medical units and medical insurance institutions. Responsible for medical expenses management, service, supervision, examination and approval, coordination, and ensure the rational use of medical insurance expenses. [1]

Insurance treatment/medical insurance for laid-off workers editor

The medical insurance treatment for laid-off workers is one of the issues that have attracted more attention, which is related to the construction of people's livelihood in China and reflects the country's humanistic care.

medical units and medical staff in medical insurance for laid-off workers should adhere to civilized medical practice, correct medical ethics, and assist medical insurance units to actively do a good job in medical management and service for laid-off workers, so as to prescribe the right medicine and use drugs rationally.

basic medical insurance benefits for employees and laid-off workers in urban units (including individual owners and employees, freelancers and migrant workers registered in this city).

All urban employers, including various enterprises, institutions, social organizations, private non-enterprise units and individual economic organizations, should provide medical insurance for migrant workers who have formed labor relations with them according to regulations.

urban workers and laid-off workers: all employers in cities and towns, including enterprises (state-owned enterprises, collective enterprises, joint-stock enterprises, foreign-invested enterprises and private enterprises), organs, institutions, social organizations, private non-enterprise units and workers;

if the insured falls ill, he should be treated in the outpatient department first. The medical expenses incurred in the outpatient department of the local designated hospital should be paid by the doctor's guarantee and IC card directly in the designated hospital, and the insufficient part should be paid in cash. Medical expenses incurred in non-designated hospitals or outpatient treatment in different places shall be paid in advance by the insured. The insured person's outpatient medical expenses and drug purchase expenses, whether incurred locally or in other places, are not included in the overall fund payment. Outpatient treatment is ineffective, or serious illness requires direct hospitalization, and hospitalization registration procedures should be handled in time.

The following information should be provided for the hospitalization registration:

1. The hospitalization certificate issued by the outpatient (emergency) doctor and the relevant inspection report;

2. The medical insurance certificate and IC card of the insured;

3. the certificate issued by the unit where the insured person works.

For the critically ill, acute and seriously ill insured patients who need emergency rescue, regardless of whether they are designated or not, they should go to the service hall of the agency to go through the admission registration formalities with relevant materials within 3 days based on the principle of first rescue and treatment. Insured employees who are hospitalized in local designated hospitals should submit their personal medical insurance and IC cards to the medical insurance department of the hospital for identity check and accounting. If the medical expenses of card-holding hospitalized employees are less than 38, yuan, they will be paid in advance by the hospital (the individual will pay the part), and those above 38, yuan will be paid in advance by the insured, and will be paid by the serious illness fund according to the prescribed proportion after discharge. Urban workers and laid-off workers: laid-off workers placed in different places and on-the-job workers on business trips and vacations who need to be hospitalized due to illness should choose local designated hospitals, and contact the unit in time to register at the service hall of the agency.

for migrant workers to participate in the basic medical insurance, the minimum payment standard, the proportion of overall fund payment and the maximum payment limit shall be implemented according to the basic medical insurance standard for urban workers in our city. Migrant workers who need hospitalization can choose medical institutions for hospitalization within the designated medical institutions of the basic medical insurance for urban workers in our city. Those who voluntarily request to return to their places of origin for treatment may seek medical treatment in the designated medical institutions of local urban workers' basic medical insurance with the consent of the medical insurance agency, and the regional medical insurance agency shall provide medical settlement services for them in a timely manner.

Article 27 of the recently promulgated Social Insurance Law of the People's Republic of China stipulates: "Individuals who have participated in the basic medical insurance for employees will not pay the basic medical insurance premium after being laid off, but will enjoy the basic medical insurance benefits according to the national regulations; If it is not reached, it can be paid to the prescribed period of time. " The core spirit of this provision is: "After being laid off, employees will no longer pay the basic medical insurance premium and enjoy the basic medical insurance benefits in accordance with state regulations;" The flexible precondition of this provision is: "the cumulative payment has reached the national fixed number of years". It is precisely because the country has no unified regulations that all localities have their own needs and do their own things, which infringes on the legitimate rights and interests of laid-off workers' medical insurance for social vulnerable groups.

expense management/medical insurance for laid-off workers editor

because there is no unified regulation in the country, all localities have their own needs and do their own things, which infringes on the legitimate rights and interests of medical insurance for laid-off workers of social vulnerable groups.

in order to give full play to the regulating function of social insurance and ensure that retired, laid-off and resigned workers get medical treatment, this method is formulated in line with the principle of "ensuring medical treatment and overcoming waste", adhering to the principle of "treating major diseases, treating minor diseases and curing no diseases" and promoting the reform of social insurance system. County laid-off pension fund management committee under the medical management office. Before the establishment of the institution, the social insurance company shall temporarily perform its duties; Each township, town and field shall set up a medical insurance management team with the trinity of party committees and governments, medical units and medical insurance institutions. Responsible for medical expenses management, service, supervision, examination and approval, coordination, and ensure the rational use of medical insurance expenses.

all retired, laid-off and resigned employees of state organs, organizations, institutions, enterprises owned by the whole people and county-level collective-owned enterprises who participate in social insurance are entitled to medical insurance benefits (the medical expenses of laid-off employees' families are not reimbursed if they are not included in the overall plan). Outpatient medical expenses are paid to all people, and they are adjusted and controlled by themselves with the payment of wages. The standards are: retired cadres and laid-off workers who participated in revolutionary work before the founding of the People's Republic of China are 1 yuan per month; Laid-off and retired workers are in 7 yuan every month.

hospitalization procedures

1. All laid-off workers who enjoy social medical insurance shall seek medical treatment in the outpatient department of the hospital specified by the medical insurance institution they belong to. If they have to be hospitalized after being diagnosed by the doctor, they must hold the illness certificate, inspection report, medical record and hospitalization notice issued by the doctor and go to the local medical insurance institution for examination before being hospitalized.

2. Emergency inpatients can be admitted to hospital for emergency treatment first, and the admission examination and approval procedures will be completed within 3 days with the emergency certificate, otherwise the hospitalization drug expenses will not be reimbursed.

3. Those who really need to be transferred to hospitals at or above the county level because of their serious illness can't be treated in the local hospitals, and the transfer certificate will be issued by their resident doctors. After being signed and agreed by the hospital president, they can be transferred to hospitals for treatment (emergency patients can be transferred to hospitals for treatment first, but they must go through the formalities of transfer for examination and approval within 5 days), and the medical and drug expenses of being transferred to hospitals for examination and treatment without approval and being hospitalized in other places without authorization will not be reimbursed.

proportion of reimbursement for hospitalization medical expenses

1. Retired cadres and laid-off workers who joined the work before the founding of the People's Republic of China, disabled people on business, third-stage silicosis patients, and second-class disabled soldiers were hospitalized due to illness, and their medical expenses were reimbursed 1%.

2. If laid-off workers have worked for more than 3 years, their medical expenses will be reimbursed by 9%.

3. For laid-off workers with working experience of 21 to 3 years or less, 85% of their medical expenses will be reimbursed.

4. If the laid-off workers have worked for less than 15 to 21 years, their medical expenses will be reimbursed by 8%.

5. If the laid-off workers have less than 15 years of service, their medical expenses will be reimbursed by 75%.

6. For retired employees, their medical expenses will be reimbursed by 75%.

7. 6% of the hospital bed fee will be reimbursed, regardless of any hospitalization method, the hospital bed fee will be charged, and the company will collect the bed fee not collected by the hospital.

settlement of hospitalization expenses

1. Before the patient is admitted to the hospital, the medical insurance institution shall pay the hospitalization expenses according to the admission procedures, and the maximum amount of each advance shall not exceed 3 yuan. If the advance payment for continuing hospitalization is insufficient, the medical unit shall issue a reminder notice, notify the medical insurance institution to pay one day in advance, and collect the self-funded part of the previous advance payment when paying the advance payment again. Otherwise, the insurance institution refuses to bear the cost of continuing hospitalization.

2. When the patient is discharged from hospital after recovery, the medical unit and I shall notify the medical insurance institution one day before discharge, and settle the medical expenses for discharge according to the provisions of the three parties. If the medical expenses for discharge are not settled on time, the medical expenses for this hospitalization will not be reimbursed, and the expenses will be deducted from the laid-off expenses.

3. When the patient is discharged from the hospital, if he needs to continue taking medicine due to his illness, the dosage of chronic diseases shall not exceed 7 to 9 days and acute diseases shall not exceed 3 to 5 days according to the regulations, otherwise, he shall be treated at his own expense.

Hospitalization medical management

1. During hospitalization, laid-off workers should consciously abide by the medical management system and obey the doctor's advice, and must not force drugs and make excessive extra demands under any excuse.

2, medical units and medical staff, should adhere to the principle of medical treatment, do suit the remedy to the case, rational drug use, overcome drug waste, enthusiasm for the treatment of laid-off workers.

3. The medical unit should manage the medical records of laid-off workers in hospital, and store hospitalization prescriptions separately and settle accounts according to the facts, and actively assist the medical insurance department in supervision, examination and management.

4. The staff of medical insurance institutions should be loyal to their duties, handle affairs impartially, manage strictly, and not be selfish, and actively assist medical units in providing hospitalization management services for laid-off workers.

5. For laid-off workers who are engaged in business and employed by the company, the outpatient expenses and hospitalization expenses during their business and employment shall be handled according to the Interim Measures. Anyone who violates the regulations, once verified, all medical expenses will be deducted from the laid-off expenses.

6. Anyone who goes out for hospitalization without permission will not be reimbursed for medical expenses.

The laid-off workers of state-owned enterprises made contributions to the country when they were on the job, and contributed to the reform when they were laid off. How can they make sacrifices after they are laid off now? I hope the country will turn the "happiness index" of laid-off workers of state-owned enterprises from ideal to reality as soon as possible.

Further reading: How to buy insurance, which is better, and teach you how to avoid these "pits" of insurance.