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Latest policies for medical insurance personal accounts

1. The new policy for the 2022 medical insurance card mainly includes three aspects: 1. Enhance the outpatient financial security function.

Starting from outpatient chronic diseases such as hypertension and diabetes that carry a heavy burden on the public, we will gradually include general outpatient medical expenses for frequently-occurring and common diseases into the scope of payment by the overall fund.

General outpatient services are co-ordinated to cover all employee medical insurance participants, and the payment ratio starts from 50%. As the fund's affordability increases, the level of protection will be gradually increased, and benefit payments can be appropriately tilted towards retirees.

Once the payment mechanism for general outpatient services is established, especially when the payment ratio of the unified fund is increased from 50% to 70%, this means that outpatient expenses can be paid by the unified fund without any difference, just like inpatient treatment.

This is extremely important and effective in reducing the outpatient burden of employees (especially retired employees and employees in need).

2. Improve the method of crediting personal accounts.

All unit payments will be credited to the overall fund, and no part will be transferred to individual accounts; all individual payments will be credited to personal accounts, and in principle personal payments shall not exceed 2%. This is not only to reduce the individual payment burden, but also to enhance the overall fund's impact on outpatient payments.

***Economic sharing function.

3. Standardize the scope of use of personal accounts.

Personal accounts can be used among immediate family members for mutual financial assistance and open use.

Doing so can not only improve the mutual financial capacity of outpatient payment among family members, but also reflect the family's self-protection function.

2. New policy on the reimbursement ratio of medical insurance in 2022: 1. Medical insurance is mainly divided into employee medical insurance and resident medical insurance, and the reimbursement ratio is also different; 2. The reimbursement ratio of employee medical insurance is divided according to the level of hospitalization expenses, ranging from 1,300 yuan to 30,000 yuan.

The reimbursement rate is 85% for between RMB 30,000 and RMB 40,000, 90% for RMB 30,000 to RMB 40,000, 95% for RMB 40,000 to RMB 100,000, and 95% for RMB 100,000 to RMB 300,000.

The reimbursement ratio between them is 85%; 3. Residential medical insurance is composed of the urban residents’ medical insurance and the new rural cooperative medical insurance.

The reimbursement ratio is 65% for first-level hospitals, with a minimum payment threshold of 300 yuan; the reimbursement ratio for second-level hospitals is 65% for less than 6,000 yuan, and 80% for more than 6,000 yuan. Among them, county second-level hospitals

The minimum payment line is 400 yuan, and the minimum payment line for municipal second-level hospitals is 600 yuan, etc.

Legal basis: Article 23 of the "Social Insurance Law of the People's Republic of China" requires employees to participate in employee basic medical insurance, and the employer and employees shall jointly pay basic medical insurance premiums in accordance with national regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other people with flexible employment can participate in the basic medical insurance for employees, and individuals must pay the basic medical insurance premiums in accordance with national regulations.