New policy of one-person medical insurance for the whole family

The Guiding Opinions of the General Office of the State Council on Establishing and Perfecting the Economic Security Mechanism for Employees' Basic Medical Insurance Outpatients clearly points out that personal accounts are mainly used to pay the out-of-pocket expenses incurred by the insured in designated medical institutions or designated retail pharmacies, and can be used to pay the medical expenses incurred by the insured and their spouses, parents and children in designated medical institutions, as well as the expenses incurred by individuals in purchasing medicines, medical devices and medical consumables in designated retail pharmacies.

The new policy of one-person medical insurance for the whole family is as follows:

1. Family members can use personal medical insurance accounts. In the past, the money in personal medical insurance could only be used by oneself. Now, according to the national conditions, the money in personal medical insurance accounts can be used by family members, and the personal accounts of children who participate in employee medical insurance can be used by parents and children, so that the whole family can benefit.

2, personal accounts can be used to pay the insured himself and his spouse, parents and children in designated medical institutions borne by the individual medical expenses. It means that the money in the personal medical insurance account can be paid to the family when the family sees a doctor in a designated hospital or a designated pharmacy, but the personal medical insurance cannot be reimbursed to the family.

"Guiding Opinions of the General Office of the State Council on Establishing and Improving the Economic Security Mechanism for Employees' Basic Medical Insurance Outpatients" Article 2 regulates the scope of personal accounts. Personal accounts are mainly used to pay out-of-pocket expenses of insured persons within the policy scope of designated medical institutions or designated retail pharmacies. It can be used to pay the medical expenses incurred by the insured and their spouses, parents and children in designated medical institutions, as well as the expenses incurred by individuals in purchasing drugs, medical devices and medical consumables in designated retail pharmacies. Explore the personal accounts of spouses, parents and children participating in the basic medical insurance for urban and rural residents. Personal accounts shall not be used for public health expenses, physical fitness or health care consumption and other expenses that are not covered by the basic medical insurance. Improve the management measures for the use of personal accounts and do a good job in the statistics of income and expenditure information.

I hope the above content can help you. Please consult a professional lawyer if you have any other questions.

Legal basis: Article 4 of People's Republic of China (PRC) Social Insurance Law.

Employers and individuals in People's Republic of China (PRC) pay social insurance premiums according to law, and have the right to inquire about payment records and personal rights records, and require social insurance agencies to provide social insurance consultation and other related services.

Individuals enjoy social insurance benefits according to law and have the right to supervise the payment of their own units.

Article 10

Employees shall participate in the basic old-age insurance, and the employer and employees shall jointly pay the basic old-age insurance premium.

Individual industrial and commercial households without employees, part-time employees who have not participated in the basic old-age insurance in the employer and other flexible employees can participate in the basic old-age insurance, and individuals pay the basic old-age insurance premium.

The measures for the endowment insurance of civil servants and staff managed by reference to the Civil Service Law shall be formulated by the State Council.