As the cornerstone of public life, changes in medical security will not only affect the rights and interests of every insured person, but also affect everyone's quality of life. So this year, what are the new changes about medical insurance? How should retirees who enjoy medical insurance be reimbursed by medical insurance when they see a doctor in other places? Let's find out:
.01
The new regulations on the payment period of medical insurance will be officially implemented from 2024
Since January 2024, many regions in mainland China have made new policy adjustments for the number of years of medical insurance contributions.
1. Tianjin has issued a new method of "actual payment plus deemed payment": male participants who join the employee medical insurance in Tianjin should have a payment period of no less than 25 years (including at least 5 years of actual payment period); Women, on the other hand, are required to pay for health insurance for at least 20 years (there is also a requirement of 5 years of actual contributions). Insured persons who meet the above requirements will be exempted from paying employee medical premiums after retirement and enjoy lifelong medical insurance benefits.
2. Jiangmen City implements a progressive plan for the payment period. The new policy stipulates a plan for the gradual adjustment of the number of years of employees' medical insurance contributions. According to this plan, by January 1, 2030, the contribution period will be 30 years for male employees and 25 years for female employees.
3. Wuhan City restricts units that fail to pay medical premiums in full. The specific standard for the number of years of medical insurance payment is: when the male insured reaches the national retirement age or decides to retire, if the total number of years of payment is not less than 30 years and the actual payment time is at least 10 years; Under the same conditions, the total number of years of contribution for female participants must reach 25 years, and the actual payment time must also meet 10 years; In such a case, they are all entitled to go through the retirement process and receive the retiree's health insurance benefits. If the payment period is insufficient, the employer should make up the payment period at one time, and can also choose to participate in the medical insurance for urban and rural residents.
It can be seen that the requirements for the number of years of medical insurance payment are not the same in different places, and it is worth noting that Ankang City, Shaanxi Province clearly stipulates the requirements for the number of years of continuous payment, and once the payment is suspended, the accumulation of continuous payment will be calculated from the beginning.
.02
How to use medical insurance reimbursement for retirees who see a doctor in other places?
As we all know, according to the relevant regulations of the mainland, as long as the medical insurance is paid, the insured can enjoy medical reimbursement. And now that the mainland has begun to implement outpatient reimbursement, it can also be reimbursed by medical insurance, which is undoubtedly a great news for people with medical insurance.
But at present, many people are more worried about how to use medical insurance reimbursement if they are not in the overall planning area?
In fact, each province will have its own medical insurance service platform, but because many people don't know, and the state takes into account more factors, it has launched a platform "National Medical Insurance Service Platform", so that no matter which province's medical insurance you are, you can do remote filing on it.
The specific steps for medical insurance filing in different places are as follows:
1. Download the "National Medical Insurance Service Platform" on your mobile phone
2. Log in to the platform, find "Remote Filing" on the homepage, and click "Remote Medical Filing Application".
3. There are two options in the filing application, if you want to see a doctor for yourself, choose "Filing for yourself". If it is to treat the elderly at home, choose "filing for others".
4. Choose the place of insurance and the place of medical treatment, if you are a medical insurance in Changsha City, you want to go to Wuhan City for medical treatment. Then the place of insurance is "Changsha City", and the place of medical treatment is "Wuhan City".
5. Select the ICP filing type according to your own situation. If you are in a long-term field, you can choose from the three options of "Retiree in a Place", "Long-term Resident in a Place", and "Permanent Worker". If it is only temporary, you can choose two options: "remote referral for medical treatment" and "other inter-provincial temporary medical personnel".
After filling in, a notice will pop up, click "I have read, start filing" after scrolling down.
Then select the start date of the ICP filing application and finally check that your information is correct. Just submit it and wait for review.
A reminder: you must remember that you must apply for a "remote filing" first, and then go to the hospital to see a doctor, otherwise you will not be able to achieve reimbursement!