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In 2023, the medical insurance system has undergone a series of reforms, including the implementation of the employee outpatient mutual aid system and the adjustment of the medical insurance inclusion standards for insured persons, which have had a certain impact on the medical insurance rebates of retirees. In this article, we'll dive into the impact of these reforms on Medicare rebates for retirees, adding some of our own understandings and perspectives.
First of all, it should be clear that medical insurance policies vary in different regions, so the criteria for medical insurance inclusion are also different. In the past, in many places, health insurance allocations were determined based on the proportion of retirees' individual pensions, while others used a fixed amount or a proportion of the local average social wage.
However, with the adjustment of medical insurance benefits, the standard of medical insurance rebates for retirees has also changed. Under normal circumstances, the medical insurance transfer under the new standard is calculated according to about 2.5% of the average pension of the locals, and the monthly transfer is unlikely to exceed 100 yuan.
So, which retirees will be affected, and will the monthly Medicare rebate be reduced by 200 yuan? We can divide into two categories of people to discuss.
The first is those with higher levels of pensions. If the previous policy was to transfer medical insurance rebates based on individual pensions, but now it is based on per capita pensions, people with high pension levels will face a large reduction. In Wuhan, Hubei Province, for example, retirees over 70 years old used to be allocated 5.1% of their own pensions, but now they are allocated 2.5% of the average pension of locals. If a retiree's pension reaches $6,000, the monthly Medicare rebate will be $200 less than in the past.
Another group of people affected are those who have been refunded from Medicare in the past, which is calculated based on the average social wage. For example, Shenzhen used to use 60% of the average social wage as the base, and the proportion of 8.05% was included, and the monthly refund amount reached 12964×60%×8.05% = 626 yuan. According to the new standard, 251 yuan per month is allocated, a decrease of 375 yuan.
However, not all retirees will receive a $200 reduction in Medicare rebates. There are three categories of retirees who will not decrease in Medicare rebates in 2023, and some will even increase.
The first is retirees with low pension levels, for them, even if they are included in the past personal pension ratio, it is only one or two hundred yuan per month, so it is unlikely to be reduced by 200 yuan per month.
The second category is those areas that have implemented the Medicare outpatient mutual aid reform, but have not adjusted the medical insurance refund standard for retirees. For example, the new standards in Beijing, Tianjin, Shanghai and other places have not changed the amount of medical insurance compared with the old standards.
The last group is those places that have not yet implemented the reform of the Medicare outpatient mutual aid system, and they can still be classified as health insurance according to the old standard. For example, Ningbo, Zhejiang Province has already been transferred to the retiree account in 2023, and the monthly transfer standard has increased by 10 yuan compared with 2022.
In summary, in 2023, all localities will begin to adjust the medical insurance treatment, except for some special areas, retirees' medical insurance rebates will generally decrease, but not all retirees will reduce by 200 yuan. It should be emphasized that despite the change in the Medicare refund standard, the overall level of health insurance coverage for retirees has still improved, because they can now enjoy outpatient reimbursement and the use of Medicare personal accounts has expanded. The aim of these reforms is to improve the equity and sustainability of health care. For individuals, they need to plan their medical spending and savings according to policy changes in their region. If you still have questions or need further discussion, please leave a message in the comment area.
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