The most prominent highlight of the reform of the medical insurance account in 2021 is to reduce the allocation of personal account balances, and at the same time to expand the overall fund. The purpose of anger is to increase the reimbursement ratio and solve the most important livelihood problem of the unpleasant and expensive medical treatment.
According to the 2021 opinion on the establishment of an outpatient mutual aid system for employees, it is clear that two plans should be made, and the two plans should establish an outpatient medical reimbursement system at the same time.
In the past, we had to rely on the proof of staying in the hospital for more than 7 days to have the possibility of reimbursement. Now outpatient medical treatment, such as headaches, diarrhea and colds and other minor diseases, can also be reimbursed in outpatient services. Moreover, it is stipulated that the reimbursement ratio shall not be less than 50%. According to the design of the billing reform method for medical insurance accounts in 2021, it is to raise the standard of outpatient reimbursement, expand the scope of outpatient reimbursement, and realize remote settlement and reimbursement in different places. Regarding the allocation of medical insurance funds to the account, the reform of the medical insurance account ratio for in-service employees and the medical insurance reform for retired employees was realized, and the billing ratio was adjusted simultaneously.
The proportion of reimbursement has reached more than 50% and about 75%. Such a high proportion also relaxes the scope and standard of use of the personal balance part of the medical insurance account, and allows individuals to use the account balance of the medical insurance card for family members, including parents, spouses and children. You can also pay for the cost of reimbursement expenses in the next year, and you can also pay for the next year’s new year medical insurance. This also relaxes the scope of use. In the past, when we purchased non-medical supplies at designated pharmacies, such as rice noodle oil Products cannot be paid. After the reform, the balance of the medical insurance account can pay for non-medical products other than health care products, such as medical insurance equipment.
Retired employees enter the personal medical insurance account according to the monthly salary base technology of 2%, and the personal account savings balance. The simultaneous reform of the medical insurance accounts of retired employees and the medical insurance accounts of in-service employees reflects the emphasis on the medical pension benefits of retired employees.
At present, the two age nodes of 35 years old and over 60 years old are the time points when the medical insurance account reimbursement expenses and different needs arise. Basically, people under the age of 35 have a relatively large demand for outpatient reimbursement and a relatively small demand for inpatient reimbursement.However, it is different for retired employees over 60 years old. Both hospitalization expenses and outpatient expenses reimbursement are in relatively large demand, because after retirement, they are older and have more diseases. The establishment of the outpatient medical mutual aid system this time is to give play to the mutual aid system that is difficult for all parties to support, so that the pension fund can be used in common use, and those who do not need to be reimbursed for medical treatment can make more money. More funds enter the overall fund, so that those who really need it can generate the greatest reimbursement benefits.
my country’s pension adjustment in 2021 involves 127 million retired employees, and these retired employees also need medical insurance protection. Therefore, after the reform of the medical insurance account billing ratio, these employees will be happier even if we are hospitalized in the past. In the current outpatient clinics, a very high percentage of reimbursements can be made for medical treatment. Medical insurance is the second largest type of insurance after endowment insurance, and it plays the most important role in building a harmonious family in an aging society. Medical insurance is currently divided into two types: urban and rural residents medical insurance and employee medical insurance. As long as the employee’s medical insurance has paid cumulatively, they can enjoy free medical reimbursement after they retire for more than 25 years or more than 30 years. What I want to emphasize is that the reform of medical insurance billing account ratio in 2021 is mainly aimed at employee medical insurance.
Every move in the medical insurance reform and a little bit of trouble in the reform of the old-age insurance can arouse the attention of the whole society. The reform of the billing method of the medical insurance account in 2021 is a contribution to the contemporary era and will benefit the future. Good thing, no less than the old-age insurance merger reform in 2014, its enduring positiveness will gradually become prominent in the next few years.
Whether it is the increase in the standard of on-the-job wages of government agencies and institutions, the 17 consecutive rises in pensions for retired employees, or the reform of the billing method for medical insurance accounts in 2021, all highlight that my country’s pension insurance and social security reform has entered the deep water area. And more and more highlights the fairness, more down-to-earth, more satisfying, the bottom of the broad masses of the people's growing demand for medical reimbursement.
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