CCTV Beijing, August 2 (Reporter Wang Jing) On August 1, the General Office of the State Council issued the "Guiding Opinions on Improving the Long-term Mechanism for Basic Medical Insurance" (hereinafter referred to as the "Guiding Opinions") announced, which is the first long-term mechanism for basic medical insurance participation in the mainland. On the same day, the Information Office of the State Council held a regular briefing on the policies of the State Council to introduce the relevant situation of the "Guiding Opinions". It is worth noting that Huang Huabo, deputy director of the National Health Insurance Administration, said: "Employee medical insurance personal account mutual aid means that the money in the personal account can be used by the family, which we summarize as 'family mutual aid can participate in insurance, help the elderly and help the young'." ”
The State Council Information Office held a regular briefing on the policies of the State Council to introduce the relevant situation of the "Guiding Opinions on Improving the Long-term Mechanism for Participation in Basic Medical Insurance".
Promote more village clinics to be included in the basic medical insurance designated points and direct settlement
Since the 18th National Congress of the Communist Party of China, the quality of basic medical insurance in mainland China has continued to improve, and the participation rate has remained stable at 95%. Among them, the resident medical insurance covers more than 900 million insured people. Huang Huabo, deputy director of the National Medical Security Administration, mentioned that the "Guiding Opinions" for some problems in the operation of the system, clarified the strengthening of permanent residence insurance, improve incentives and constraints, improve financing policies, improve precise expansion, strengthen publicity and mobilization, strengthen departmental linkage, guarantee financial support and other mechanisms, after the release, the insured can enjoy five dividends - "release, expansion, promotion, reward, convenience".
"Liberalization" refers to the further relaxation of household registration restrictions for insurance participation, so that primary and secondary school students and preschool children can participate in insurance in their usual place of residence. It is also proposed that megacities should abolish the household registration restrictions on flexible employees, migrant workers, and new forms of employment to participate in employee medical insurance.
"Expansion" refers to the expansion of the scope of mutual aid in the personal account of employees' medical insurance, from family members to close relatives.
"Mention" refers to the increase in the ceiling line of critical illness insurance for the insured persons who have continuously participated in the resident medical insurance, which is what we often call the maximum payment limit.
"Award" refers to the establishment of a reward mechanism for zero reimbursement personnel in the resident medical insurance fund, and the insured people who do not enjoy reimbursement in the current year will raise the ceiling of serious illness insurance in the following year.
"Convenience" refers to making it more convenient for insured persons to enjoy medical services nearby, promoting more village clinics to be included in the basic medical insurance designation, and direct settlement, promoting more centralized procurement of drugs at the grassroots level, and releasing more centralized procurement dividends to the grassroots level.
Chengdu, Sichuan, the doctor took the pulse for consultation.
The scope of mutual assistance in the personal account of employees' medical insurance has been expanded to close relatives
Huang Huabo said that the "Guiding Opinions" not only continue the mutual aid of employees' medical insurance personal accounts, but also expand the scope of mutual aid to close relatives.
"Last year, there were some rumors on the Internet about the cancellation of personal accounts for employees' medical insurance, and we issued a statement to refute the rumors in a timely manner." Huang Huabo pointed out that the mutual aid of the personal account of the employee's medical insurance means that the money in the personal account can be used by the family, which can be summarized as "family mutual aid can participate in the insurance and help the elderly and help the young".
Huang Huabo further pointed out that the "Guiding Opinions" not only continued the mutual aid of employees' medical insurance personal accounts, but also further optimized the mutual aid policy and relaxed the scope of mutual aid. On the one hand, the scope of mutual aid has been extended to close relatives. The document stipulates that the personal account of the employee's medical insurance can be used for the payment of resident medical insurance by his close relatives.
Among them, close relatives refer to spouses, parents, children, siblings, grandparents, grandchildren, and grandchildren as stipulated in the Civil Code of the People's Republic of China. If these close relatives are insured, they can be settled using the mutual aid person's personal account when reimbursing medical expenses. On the other hand, the mutual aid area has been further expanded. We plan to take two steps, the first step is to expand the scope of mutual aid to the use of cross-provincial areas within the province by the end of this year, and the second step is to accelerate the promotion of cross-provincial mutual aid next year.
Huang Huabo also emphasized that family mutual aid is mainly the money in the personal accounts of mutual aid workers, excluding the part of the pooled fund.
Hospital Billing Window
Further consolidate the achievements of "online office" and "handheld office".
The "Guiding Opinions" mentioned that the medical insurance department and the tax department should enrich the insurance payment methods, expand the inquiry channels for individual payment and medical expenses included in the medical insurance settlement, and provide online and offline diversified and convenient insurance payment and other services for the insured.
At present, the mainland has realized the "online office" of enterprise social security payment business and the "handheld office" of individual social security payment business, and the level of payment facilitation has been significantly improved. Zheng Wenmin, director of the Department of Social Insurance Premiums of the State Administration of Taxation, said at the briefing that the tax department will cooperate and cooperate closely with the medical insurance and other departments to further consolidate the achievements of "online office" and "handheld office".
Specifically, on the basis of realizing the comprehensive online handling of basic matters such as medical insurance declaration and payment, the tax department will further incorporate related matters such as the signing of bank deduction agreements, personal payment information inquiry, and payment progress notification reminders into the content of "online office" and "online office". At the same time, it will promote the online "one-window service" and offline "one-hall joint office" for medical insurance handling and tax collection business, so as to provide "one-stop" services for the insured people. In addition, it will also closely connect with the comprehensive social governance network, continue to improve the "grid" service of medical insurance payment, and facilitate the insured people to pay "nearby" and "special affairs".
In terms of responding to public appeals, the tax department will continue to deepen the working mechanisms such as "the people call me", "handle the complaint immediately" and "handle it before the lawsuit", smooth the channels for collecting the appeals of the insured people, and further improve the efficiency of handling problems. The 12366 tax payment service hotline of the tax authorities will provide 24-hour online consultation. At the same time, we will focus on the needs of special groups such as the elderly and the disabled, and provide personalized measures such as priority handling in the tax service hall, so as to effectively implement the party's good policies to every insured person, so as to benefit and share with the whole people.
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