Provisions of Sichuan Province on Refund of Medical Insurance Cards

Medical insurance reimbursement standards for employees and retirees in Sichuan will be adjusted. How will it affect you? Will the treatment be reduced? Recently, Sichuan issued the Detailed Rules for the Implementation of Economic Security for Outpatients with Basic Medical Insurance for Employees in Sichuan Province, and Chengdu also issued the Detailed Rules for the Implementation of Establishing and Improving the Economic Security Mechanism for Outpatients with Basic Medical Insurance for Employees in Chengdu. It is clear that from June 5438+ 10, 2023, the personal account of medical insurance will be adjusted and will no longer be included in the treatment according to the old method, which means that the medical insurance refund for on-the-job and retirees will change.

It should be noted that the scope of this release is only for Sichuan Province and Chengdu, and the implementation rules have not been released elsewhere. However, according to the notice issued by Sichuan at the end of last year, "Implementation Measures for Establishing and Improving the Economic Security Mechanism for Employees' Basic Medical Insurance Outpatients in Sichuan Province", it is proposed that all localities should issue implementation rules before the end of 2022 10, and it is expected that other places will follow suit.

Then, with the release of the implementation rules, what changes will be made to the medical insurance benefits of working and retired people in Sichuan? Will the treatment be reduced?

First, the medical insurance reimbursement standard was adjusted, and the included amount was reduced. According to the implementation rules, in terms of medical insurance reimbursement for employees, part of the medical insurance expenses paid by the unit are no longer included in the personal account, and only 2% of the medical insurance expenses paid by the individual enter the account. Retirees are counted as 2.8% of the per capita pension.

If it is according to the old standard, the amount of medical insurance refund is more. Take Chengdu as an example.

On-the-job employees under the age of 50 can increase their payment base by 0.0 1% every year, and transfer them to personal accounts; For those over 50 years old, the payment base will be increased by 0.025% every 1 year.

Retirees are transferred to personal accounts according to 2% of the average salary of employees in Chengdu last year, and the transfer ratio will increase by 0.025% after 1 one year old.

We can compare the amount of medical insurance refund for retirees and calculate according to the old method. According to the data of Chengdu, the average wage of employees in all units in 202 1 town is 9 1857 yuan, and the corresponding average monthly wage is 7655 yuan, so the amount that retirees can transfer at least every month is 7655*2%= 153 yuan. According to the new method, that is, according to 2.8% of the per capita pension, the per capita pension in Sichuan is about 3,000 yuan, assuming that Chengdu is 3,500 yuan, then the monthly medical insurance refund is 98 yuan. Compared with 153 yuan, at least reduce 55 yuan.

Second, the change of medical insurance reimbursement standard does not mean the reduction of medical insurance treatment level, because you can enjoy outpatient reimbursement and other treatment. From June 5438+October 2023 10, the general outpatient expenses will be included in the payment scope of the employee medical insurance fund, which means that the insured can enjoy outpatient reimbursement. The deductible for reimbursement is also relatively low. For example, the deductible line for middle-aged workers in 200 yuan is 150 yuan, and the reimbursement ceiling line for retirees is 2,000 yuan for employees and 2,500 yuan for retirees.

Moreover, the money in the personal account of medical insurance can be used not only by myself, but also by spouses, parents and children, which improves the efficiency of the use of funds.

To sum up, Sichuan recently officially announced the detailed rules for the provincial-level implementation of the basic medical insurance for employees, and Chengdu also issued the detailed rules at the same time. It is estimated that other places will announce them one after another. Starting from June 65438+ 10, 2023, the medical insurance refund benefits for employees and retirees will change, and the amount involved will decrease. However, the treatment of outpatient reimbursement has been increased, and the protection of medical insurance is better. In addition, spouses, parents and children can also use the money in the insured person's personal account, which avoids the deep sleep of funds and the overall medical insurance benefits have not been reduced.