China-Singapore 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 has increased by 30 yuan. Medical insurance payment for testing items...Your medical insurance has these changes, come to know it!
Photo of the new latitude and longitude Xiong Jiali in the picture
Medical insurance payment changes
Changes in the payment of medical insurance are mainly reflected in the government subsidies and the upper and lower bases of medical insurance contributions for employees.
With regard to government subsidies, on June 17, the National Medical Insurance Bureau, the Ministry of Finance, and the State Administration of Taxation jointly issued a notice requesting that the per capita financial subsidy standard for urban and rural residents' basic medical insurance be increased by 30 yuan in 2020, reaching no less than 550 yuan per person per year . In principle, the individual payment standard has been increased by 30 yuan simultaneously, reaching 280 yuan per person per year.
Regarding the adjustment of the upper and lower bases of employee medical insurance contributions, according to incomplete statistics from China-Singapore Jingwei client, as of July 3, Fujian, Hebei, Beijing, and Jilin have issued relevant measures to adjust the upper and lower bases of employee medical insurance contributions in 20020.
On June 29, Fujian Province made it clear that according to the average annual wage of employees in all urban units in the province in 2019 is 69768 yuan, the upper and lower limits of the monthly medical insurance payment base for Fujian employees in 2020 will be adjusted to 17442 yuan and 3488.4 yuan respectively. It will be implemented from July 1.
On June 30, Hebei issued a notice that, from July 1, 2020, the basic medical insurance (including maternity insurance) for employees at the same level in Hebei Province will be based on the average salary of all employees in urban units of the province in 2019 ”) 60,841 yuan to verify the individual payment base, lower than the social average salary, the 2019 social average salary as the payment base, higher than the social average salary, the actual salary as the payment base.
On July 1, Beijing adjusted the upper and lower limits of the basic medical insurance premiums for employees in 2020 to 29732 yuan and 5360 yuan, respectively, and the flexible employees who were entrusted by individuals to pay monthly basic medical insurance premiums of 485.66 yuan.
On the same day, Jilin issued the “Notice on Adjusting the Provincial Direct Medical Insurance Payment Baseline Up and Down Line” to clarify that the average social wages of employees on duty starting from July 1 will be implemented according to the average wage of 61,061 yuan for the full-caliber urban unit employees in the province in 2019, and the monthly average wage It is 5088.42 yuan. The upper limit of the basic monthly payment base for basic medical insurance for employees is adjusted to 15265.26 yuan, and the lower limit is adjusted to 3053.05 yuan. The execution 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 bases of the upper and lower limits of medical insurance contributions of employees is an important measure to reduce taxes and fees, optimize the business environment, and improve the social insurance system.
Medical preservation folder information map. Photograph by Zhang Yanzheng
Raise the level of critical illness insurance
In order to improve the treatment guarantee mechanism, the State Medical Insurance Bureau and other departments have demanded the consolidation of the critical illness insurance protection level. Full implementation of the minimum payment line will be reduced and unified to half of the per capita disposable income of residents. The payment rate within the policy range will be increased to 60%, and areas with conditions are encouraged to explore the cancellation of the ceiling line.
Tianjin proposed to increase the reimbursement treatment for critical illness insurance. The unified critical illness insurance payment line shall be determined in principle at 50% of the resident per capita disposable income of the previous year. Increase the critical illness insurance threshold to the 100,000 (inclusive) fee segment, the payment rate will be increased from 50% to 60%; 100,000 to 200,000 (inclusive) fee segment, the payment rate will be increased from 60% to 65%; 20 From 10,000 yuan to 300,000 yuan (inclusive), the payment rate remains unchanged at 70%.
Tianjin also requested that intensified payment for serious illness insurance be increased. Continue to implement the policy of preferential payment of critical illness insurance to the difficult groups. For the difficult groups participating in basic medical insurance, the critical illness insurance threshold will be reduced by 50% on the basis of ordinary insured persons, the payment rate will be increased by 5 percentage points, the capping line will be cancelled, and the serious illness will be further resolved. Fee burden.
Beijing made it clear that after participating in the basic medical insurance for urban employees in the previous year, individuals who have participated in the basic medical insurance for urban employees in the previous year shall pay for their own medical expenses within the scope of the basic medical insurance policy, after deducting the unit's supplementary medical insurance and medical assistance for social assistance, The part that exceeds the minimum payment standard (1.3 times the minimum payment standard for serious illness insurance for urban and rural residents) is included in the scope of medical insurance for serious illness of urban employees.
Beijing pointed out that the personal medical expenses of 50,000 yuan (inclusive) accumulated by individuals above and below the threshold (excluding) will be paid 60% by the large-scale medical mutual assistance funds of urban employees; individuals exceeding 50,000 yuan (excluding) For self-paying medical expenses, 70% of the large amount of mutual medical assistance funds will be paid by urban employees, and there is no cap. The urban workers' medical insurance for serious illness is settled once a year.
Jiangsu requires that the low-income population fully implement the policy of reducing the critical illness insurance threshold and increasing the reimbursement ratio of each reimbursement segment. The coverage of critical illness insurance can be extended from inpatient and outpatient special diseases to outpatient chronic diseases, and the minimum reimbursement rate within the policy range is increased to 60%. Carry out special investigations for low-income people to participate in basic medical insurance to ensure that low-income people should be covered and paid.
National Medical Insurance Bureau data map. China-Singapore Jingwei Dong Xiangyishe
Nucleic acid testing project medical insurance payment
In the face of the sudden new coronary pneumonia epidemic, the National Medical Insurance Bureau and other departments issued a notice as early as January this year to adopt special reimbursement policies for patients diagnosed with "new coronavirus infection pneumonia." It will also extend the coverage of the comprehensive guarantee policy established for diagnosed patients to suspected patients as defined by the Health Care Commission's diagnosis and treatment guidelines, and relieve the suspected patients of their own burden.
On June 19, the National Medical Security Administration further issued a notice clarifying that, based on comprehensive consideration of the needs of the new coronavirus pneumonia prevention and control work, the ability of the local medical insurance fund to pay, and other factors, the nucleic acid and antibody against the new coronavirus will be carried out according to the procedure. Test items and related consumables are included in the provincial medical insurance diagnosis and treatment project catalogue, and payment conditions are determined synchronously.
According to incomplete statistics from the China-Singapore latitude and longitude clients, as of July 3, at least Shanghai, Chongqing, Hubei, Hunan, Zhejiang, Fujian, Shanxi, Sichuan, Anhui, Jilin, and Heilongjiang have announced relevant measures.
Among them, Chongqing made it clear that when the new employees of the urban employee medical insurance and the cooperative medical insurance of urban and rural residents in Chongqing City are newly admitted to hospitals or are undergoing fever treatment, their "new coronavirus nucleic acid test" will be included in the project and in vitro diagnostic kits in Chongqing. Medicare reimbursement.
Fujian requires that the detection of new coronavirus nucleic acids be temporarily included in the payment range of inpatient medical insurance in Fujian Province. There is no individual pay-as-you-go ratio, and reimbursement is based on the basic medical insurance policies for employees and urban and rural residents.
Jilin said that the new coronavirus nucleic acid detection medical service project will be included in the Jilin Province basic medical insurance diagnosis and treatment project and medical service facility project directory, and the new coronavirus nucleic acid detection kit will be included in the Jilin Province basic medical insurance medical consumables catalog. The expenses for the detection of nucleic acid for new coronavirus in accordance with the regulations shall be included in the payment scope of the Jilin Basic Medical Insurance Fund. (China-Singapore Jingwei APP)
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