2022 New Medical Insurance Card Policy

1. The new 2022 medical insurance card policy mainly includes three aspects:

1. Enhance the outpatient financial security function. Starting from outpatient chronic diseases such as hypertension and diabetes that carry a heavy burden on the public, we will gradually include general outpatient medical expenses for frequently-occurring and common diseases into the scope of payment by the overall fund. General outpatient services are co-ordinated to cover all employee medical insurance participants, and the payment ratio starts from 50%. As the fund's affordability increases, the level of protection will be gradually increased, and benefit payments can be appropriately tilted towards retirees. Once the payment mechanism for general outpatient services is established, especially when the payment ratio of the unified fund is increased from 50% to 70%, this means that outpatient expenses can be shared and paid by the unified fund without any difference, just like inpatient treatment. This is extremely important and effective in reducing the outpatient burden of employees (especially retired employees and employees in need).

2. Improve the personal account accounting method. All unit payments will be credited to the overall fund, and no part will be transferred to individual accounts; all individual payments will be credited to personal accounts, and in principle personal payments shall not exceed 2%. This is not only to reduce the individual payment burden, but also to enhance the overall fund's impact on outpatient payments. ***Economic sharing function.

3. Standardize the scope of use of personal accounts. Personal accounts can be used among immediate family members for mutual aid and financial support. Doing so can not only improve the mutual financial ability of outpatient payment among family members, but also reflect the family's self-protection function.

2. New policy on the reimbursement ratio of medical insurance in 2022:

1. Medical insurance is mainly divided into employee medical insurance and resident medical insurance, and the reimbursement ratio is also different;

2. The reimbursement ratio of employee medical insurance is divided according to the level of hospitalization expenses. The reimbursement ratio is 85% for those between 1,300 yuan and 30,000 yuan, 90% for those between 30,000 yuan and 40,000 yuan, and 90% for those between 40,000 yuan. The reimbursement rate for those between RMB 100,000 and RMB 100,000 is 95%, and the reimbursement rate for RMB 100,000 to RMB 300,000 is 85%;

3. Residential medical insurance is composed of urban residents’ medical insurance and new rural cooperative medical insurance. composition. The reimbursement ratio is 65% for first-level hospitals, with a minimum payment threshold of 300 yuan; the reimbursement ratio for second-level hospitals is 65% for less than 6,000 yuan, and 80% for more than 6,000 yuan. Among them, county second-level hospitals The minimum payment line is 400 yuan, and the minimum payment line for municipal second-level hospitals is 600 yuan.

Legal basis:

"Social Insurance Law of the People's Republic of China"

Article 23

Employees shall participate in For basic medical insurance for employees, the employer and employees shall jointly pay the basic medical insurance premiums in accordance with national regulations.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees in the employer, and other flexible employment personnel can participate in the basic medical insurance for employees, and individuals must pay for the basic medical insurance in accordance with national regulations. fee.