Zhongxin Jingwei Client July 4 (Xiong Jiali) Recently, the state announced a number of policies related to medical insurance. The per capita financial subsidy standard for medical insurance increased the 30 yuan, adjusted the upper and lower base of medical insurance contributions for employees in many places, improved the protection level of serious illness insurance, and paid medical insurance for nucleic acid testing projects & HELIP; … There are these changes in your medical insurance. Come and find out!
Photo by Xin Jingwei Xiong Jiali in the data map
Medical insurance contributions have changed.
Changes in medical insurance contributions are mainly reflected in government subsidies and the upper and lower base of medical insurance contributions for employees.
In terms of government subsidies, on June 17th, the National Medical Insurance Bureau, the Ministry of Finance and the State Taxation Administration of The People’s Republic of China jointly issued a notice, demanding that in 2020, the per capita financial subsidy standard of basic medical insurance for urban and rural residents should be increased by 30 yuan, reaching a level not lower than that of 550 yuan per person per year. In principle, the individual payment standard will be raised simultaneously in 30 yuan, reaching 280 yuan per person per year.
In terms of adjusting the upper and lower base of employee medical insurance contributions, according to the incomplete statistics of Zhongxin Jingwei client, as of July 3, Fujian, Hebei, Beijing and Jilin have issued relevant measures to adjust the upper and lower base of employee medical insurance contributions in 2020.
On June 29th, Fujian Province made it clear that according to the average annual salary of employees in all-caliber urban units in the province in 2019, the upper and lower limits of the monthly payment base of medical insurance for employees in Fujian Province in 2020 will be adjusted to 17,442 yuan and 3,488.4 yuan respectively, and will be implemented from July 1st, 2020.
On June 30, Hebei issued a notice. Since July 1, 2020, the basic medical insurance (including maternity insurance) for employees at the same level in Hebei Province has been approved according to the average salary of employees in all-caliber urban units in the province in 2019 (referred to as "social wage") of 60,841 yuan. If it is lower than the social wage, it will be based on the social wage in 2019, and if it is higher than the social wage, it will be based on the actual wage.
On July 1, 2020, Beijing adjusted the upper and lower payment bases of employees’ basic medical insurance premiums to 29,732 yuan and 5,360 yuan respectively, and the flexible employees entrusted by individuals paid employees’ basic medical insurance premiums of 485.66 yuan per month.
On the same day, Jilin issued the "Notice on Adjusting the Payment Base of Provincial Medical Insurance", which made it clear that the average social wage of employees on the job from July 1 was implemented according to the average wage of employees in full-caliber urban units in the province in 2019, with an average monthly wage of 5088.42 yuan. The upper limit of individual monthly payment base of employee basic medical insurance is adjusted to 15,265.26 yuan, and the lower limit is adjusted to 3,053.05 yuan. The implementation period of the upper and lower limits of the payment base is from July 1, 2020 to June 30, 2021.
It is understood that adjusting the base of the upper and lower limits of employee medical insurance contributions is an important measure to reduce taxes and fees, optimize the business environment and improve the social insurance system.
Medical insurance passbook data map. Zhongxin Jingwei Zhang Yanzheng photo
Improve the level of serious illness insurance.
In order to improve the treatment guarantee mechanism, the National Medical Insurance Bureau and other departments require to consolidate the level of serious illness insurance protection. Fully implement the deductible line to reduce and unify it to half of the per capita disposable income of residents, and increase the proportion of payment within the policy to 60%, and encourage qualified areas to explore the cancellation of the ceiling line.
Tianjin proposed to improve the reimbursement of major illness insurance. Unified deductible for serious illness insurance is determined in principle by 50% of the per capita disposable income of residents in the previous year. The deductible line of serious illness insurance will be increased to 100,000 yuan (inclusive), and the payment ratio will be increased from 50% to 60%; From 100,000 yuan to 200,000 yuan (inclusive), the payment ratio will be increased from 60% to 65%; For the expenses of 200,000 yuan to 300,000 yuan (inclusive), the payment ratio will remain unchanged at 70%.
Tianjin also requested to increase the tilt payment of major illness insurance. We will continue to implement the policy of inclined payment of serious illness insurance to the disadvantaged groups. For the disadvantaged groups who participate in basic medical insurance, the minimum payment standard for serious illness insurance will be reduced by 50% on the basis of ordinary insured persons, and the payment ratio will be increased by 5 percentage points, and the capping line will be cancelled to further resolve the burden of serious illness expenses.
Beijing has made it clear that after the insured persons of basic medical insurance for urban workers enjoyed the basic medical insurance benefits for urban workers in the previous year, the medical expenses paid by individuals within the scope of basic medical insurance policy, after deducting the amount of supplementary medical insurance and medical assistance for social assistance objects, exceeded the threshold (1.3 times of the threshold for urban and rural residents’ serious illness insurance) and were included in the scope of medical insurance for urban workers’ serious illness.
Beijing pointed out that the medical expenses paid by individuals above (excluding) Qifubiaozhun and within 50,000 yuan (inclusive) will be paid by 60% of the large medical mutual funds of urban workers; More than 50 thousand yuan (excluding) above the individual pays medical expenses, 70% of which is paid by the large medical mutual aid funds of urban workers, and the upper limit is not capped. Medical insurance for serious illness of urban workers is settled once a year.
Jiangsu requires that the policy of reducing the deductible line of major illness insurance for low-income population and increasing the reimbursement ratio of each reimbursement section be fully implemented. The coverage of serious illness insurance can be expanded from special diseases in hospitalization and outpatient service to chronic diseases in outpatient service, and the minimum reimbursement rate within the policy scope can be increased to 60%. Carry out special investigations on low-income people’s participation in basic medical insurance to ensure that low-income people should be fully insured and paid.
National medical insurance bureau data map. Zhongxin Jingwei Dong Xiangyi photo
Medical insurance payment for nucleic acid detection project
Faced with the sudden outbreak of COVID-19, the National Medical Insurance Bureau and other departments issued a notice as early as January this year, and adopted a special reimbursement policy for patients diagnosed as "pneumonia in novel coronavirus". It will also expand the coverage of the comprehensive security policy established for confirmed patients to suspected patients with clear guidelines for diagnosis and treatment by the Health and Wellness Commission, so as to avoid the personal burden of suspected patients.
On June 19th, the National Health Insurance Bureau further issued a notice, which made it clear that, on the basis of comprehensive consideration of the needs of prevention and control work in novel coronavirus and the payment ability of the local medical insurance fund, the nucleic acid and antibody testing items and related consumables carried out for Covid-19 should be included in the provincial medical insurance diagnosis and treatment items according to procedures, and the payment conditions should be determined simultaneously.
According to the incomplete statistics of Sino-Singapore Jingwei client, as of July 3, at least eleven places including Shanghai, Chongqing, Hubei, Hunan, Zhejiang, Fujian, Shanxi, Sichuan, Anhui, Jilin and Heilongjiang have announced relevant measures.
Among them, Chongqing has made it clear that the items and in-vitro diagnostic kits of "novel coronavirus nucleic acid detection" accepted by the insured persons of urban workers’ medical insurance and urban-rural residents’ cooperative medical insurance in Chongqing when they are newly hospitalized or treated in a fever clinic are included in Chongqing’s medical insurance reimbursement.
Fujian requires that Covid-19 nucleic acid testing be temporarily included in the scope of hospitalization medical insurance payment in Fujian Province, without setting the proportion of individual paying first, and be reimbursed according to the basic medical insurance policy for employees and urban and rural residents.
Jilin indicated that novel coronavirus nucleic acid detection medical service project will be included in the list of basic medical insurance diagnosis and treatment projects and medical service facilities in Jilin Province, novel coronavirus nucleic acid detection kit will be included in the list of medical consumables in basic medical insurance in Jilin Province, and the expenses for Covid-19 nucleic acid detection in designated medical institutions in basic medical insurance will be included in the payment scope of basic medical insurance fund in Jilin Province. (Zhongxin Jingwei APP)
