1, the part paid by the medical insurance unit is no longer included in the personal account.
2. Outpatient chronic diseases and common diseases can be reimbursed.
3. Strengthen the supervision and management of medical insurance funds.
4. Personal medical insurance account can pay the medical expenses of family members (specific application steps).
Let's have a look!
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First, the payment of medical insurance units is no longer included in personal accounts.
At present, the funds in the personal account of medical insurance consist of two parts:
1, individual contributions of employees
2. The employer pays 30% of the medical insurance premium.
After the reform of individual accounts, individual contributions are still included in individual accounts, but unit contributions are no longer included in individual accounts and are all included in the overall fund.
Many people don't understand that the adjustment of medical insurance personal accounts will reduce the amount of money remitted into personal accounts. In fact, the employee medical insurance personal account is a reform measure in a specific historical period, and its security function has been difficult to meet people's security needs at this stage.
"For example, the money in a personal account is not used at ordinary times, and it is not enough to use it; Some people illegally use the money in their personal accounts, and the medical insurance fund can't protect them at all. However, transferring some personal accounts to the overall fund and improving the security of the outpatient overall fund can further play the role of the medical insurance fund and meet people's security needs.
Second, outpatient reimbursement for chronic diseases and common diseases.
If you go to the outpatient department of the hospital and fail to meet the hospitalization standard, the medical expenses shall be borne by the medical insurance personal account or at your own expense. If the amount of personal account is insufficient, common diseases and chronic diseases will cost a lot of medical expenses, especially some patients with chronic diseases, who need long-term drug control and have a heavy personal burden.
In order to meet the reimbursement standard, some people choose "minor illness and serious illness", that is, they will be forcibly hospitalized if they fail to meet the hospitalization standard, which is actually a waste of medical resources.
The inclusion of chronic diseases and common diseases in the scope of reimbursement will make the coverage of medical insurance wider and stronger, reduce the burden of individual medical treatment, and avoid the situation of "minor illness and big care", "minor illness and big treatment" and "crowded hospitalization".
Third, strengthen the supervision and management of medical insurance funds.
The meeting also made it clear that it is necessary to strengthen the supervision and management of medical insurance funds, improve the auditing and internal control system, severely investigate and deal with illegal acts such as false hospitalization and fraudulent insurance, and improve the payment mechanism that is suitable for outpatient economic security.
Four, the personal account of medical insurance can pay for family medical expenses.
In the same family, this phenomenon often exists: some people have enough personal medical insurance accounts but don't need to use them, and some people have a heavy medical burden because their personal medical insurance accounts cannot make ends meet.
After the reform, the scope of personal account will be further expanded, which can be used to pay the out-of-pocket expenses of insured employees within the policy scope of designated medical institutions or designated retail pharmacies, as well as the medical expenses incurred by employees and their spouses, parents and children in designated medical institutions of medical insurance, as well as the expenses incurred by individuals in purchasing drugs and medical consumables in designated retail pharmacies.
More breakthrough is that the personal contributions of spouses, parents and children who participate in the basic medical insurance for urban and rural residents can also be paid by employees' personal accounts in the future.
Here comes the point! How to apply?
There are two ways to deal with "family assistance" in Fujian:
1, window processing
You can apply for the establishment of family account in the window of the medical insurance agency. In the process of handling, you need to provide: valid identity information of yourself and your family members, and you need to sign a family relationship statement.
2. Online processing
The specific operation steps are as follows:
1. Create a family * * * assistance. First, enter the "Civil Administration" APP or the "Fujian Medical Insurance" WeChat applet. After logging in successfully, click "Family Assistance". If the insured does not join the family assistance and is not invited, the insured of "employee insurance" can create a family assistance.
Then enter the relevant interface of creating family economy, fill in relevant information, and click OK after completion to create success.
2. Invite New Members In the first interface of family economy, click Invite New Members to add members, fill in relevant contents and send invitations. After the invitation is successful, you can choose local authentication or invitation authentication on the home page. (The invitee must have a normal social security card and be insured in Fujian Province in order to be invited successfully. )
After the creator chooses invitation authentication, he will share it through the link, or the invitee will enter the family economy by himself, and will prompt the invitation record (/kloc-valid within 0/5 days). The invitee can choose to refuse to join or agree to join, click to agree to join, fill in relevant information, and enter the economic relationship of the founder's family through face recognition. (Invitees will receive WeChat message push)
The creator can also pass the local authentication, and the local authentication can directly pass the face recognition of the invitee:
3. Manage the family * * * economy (founder) (1)*** economic account transfer. Members in the family * * economy can transfer the family * * economic account, click the home page of the family * * * economy to enter the family * * * economy, and then enter the * * * economic family transfer to transfer the amount. 0)。
(2) Dissolving the family * * * Economic relationship The founder of the family * * * economic relationship can dissolve the family * * * economic relationship, select the reason for dissolution, and enter the reason description to dissolve the family * * * economic relationship.
(3) The creator of deleting family members can delete the relationship by managing the deletion of family members among family members. After entering the delete page, select the object to be deleted and confirm that the deletion is successful.
4. Manage the family economy (other economic members)
(1) Other members who quit the family economy can take the initiative to apply to quit the family economy and enter the family economy. After face verification, they can quit the family economy.
(2) Transfer funds from the * * * economic account. Other * * economic members can also transfer funds for the family * * *, and then click the * * economic account transfer from the management family * * to transfer funds (only the insured employees can transfer funds, and the part with an account exceeding 2,000 can be transferred to the * * * economic account, and the transfer amount needs to be >; 0)。
finally
In order not to affect the normal use of family account.
Everyone should pay attention to social security is not to pay off!
If you are in the middle of leaving your job and jumping ship
Social security is suspended.
Remember to run a social security agency ~