Personal accounts of employee medical insurance are for family members. What are the highlights of this medical reform?

After the medical reform, there have been many major changes in employee medical insurance, among which the highlights are that the outpatient expenses of employee medical insurance should be included in the reimbursement, the unit payment will no longer enter the personal account, and family members can use the personal account.

On August 26th, the National Medical Insurance Bureau issued "Guiding Opinions on Establishing and Perfecting the Economic Security Mechanism for Employees' Basic Medical Insurance Outpatients (Draft for Comment)", in which the relevant opinions are closely related to every insured office worker and deserve careful analysis.

First, establish and improve the overall guarantee mechanism for medical expenses in general outpatient clinics. Many common outpatient medical expenses will be gradually included in the scope of overall fund payment, such as hypertension, diabetes and other diseases with a large number of patients and heavy burden on hospitals. According to the opinion draft, chronic outpatient diseases paid by the overall fund can be gradually improved, and the coverage will be wider, which will benefit everyone. This provision will cover all the insured.

The personal account calculation method has also been improved, and the unit payment no longer enters the personal account. To put it simply, before the reform, some of the money paid by the company went into personal accounts, and after the reform, all of it went into overall accounts, not personal accounts. It is stipulated in the opinion that all the basic medical insurance premiums paid by the unit are included in the overall fund, and the individual accounts of employees are included in the basic medical insurance premiums paid by individuals, and personal accounts are only included in the individual contributions. In this way, there will be less money in personal accounts, that is, less money that we can use directly. On the surface, this is not good for us, but in fact, more money is invested in improving the outpatient service system and improving the outpatient service security.

The most striking thing is that the use of personal accounts has expanded. After this medical reform, the employee's personal medical insurance account can pay the expenses of the employee's spouse, parents and children. When we use medical insurance, we often feel that children can't use it when they are healthy, and patients can't use it enough. Expanding the use of personal accounts is not only beneficial to us personally, but also beneficial to the whole family. This regulation is more humane and reasonable, which is conducive to the harmony and mutual assistance of our family.