1. The inclusion standard of the individual accounts of employees of the employing unit is determined according to 2% of the insured payment base, and all the basic medical insurance premiums paid by the unit are included in the overall fund; In principle, the individual accounts of retirees are included in the overall fund according to the quota, and the inclusion standard is determined according to 2.5% of the average basic pension level in our city in 20021year.

2, to participate in the medical insurance of employees in our city, flexible employment, in principle, no longer give outpatient and drug subsidies, not included in the personal account.

3. If the insured reaches the statutory retirement age, and the accumulated payment period reaches the prescribed period of this Municipality or the payment is made according to the regulations, the retirement policy shall be implemented from the month following the retirement formalities.

4, personal account funds shall not be used for public * * * medical expenses, physical fitness or medical care consumption does not belong to the scope of basic medical insurance payment, and the national provisions of the basic medical insurance fund will not pay the project expenditure.

5. The carry-over use and inheritance of personal account funds shall be carried out in accordance with the relevant provisions of this Municipality on the management of personal accounts.

Why should we carry out the reform of medical insurance for workers' outpatient service? Like other cities in China, Wuhan's employee medical insurance is a guarantee mechanism combining pooling funds and individual accounts. Prior to this, the overall fund was used to ensure serious illness in hospitalization and outpatient service, and the personal account was used to ensure minor illness in outpatient service. There have been cases in which insured employees "can't spend without illness and can't use without illness". On the one hand, more than 60% of individual accounts in cities deposit funds in young and middle-aged accounts; On the other hand, the personal account balance of retired and sick people is not enough, and the burden of outpatient individuals at their own expense is heavier.

The main features of this reform are as follows: First, the personal account setting and some functions of employee medical insurance are retained, and it continues to play its cumulative role. Second, give full play to the guarantee function of the overall fund, include the general outpatient expenses in the reimbursement scope of the overall fund, and effectively help the insured employees who need medical treatment.

The above contents refer to Wuhan Life Network-Interpretation of the new policy of medical insurance reform in Wuhan in 2023