According to the New Deal, starting from this month, Nanjing will unify the municipal medical insurance policies, handling services and fund raising, and all insured employees will no longer be subject to geographical restrictions in holding cards for medical treatment and purchasing medicines in big cities. At the same time, the labor relations of the insured are transferred within the scope of the city and district, and the medical insurance data and registration information are mutually recognized.
In the past, the medical insurance information in the urban area and the five districts did not recognize each other, and the insured had a lot of inconvenience. For example, if you are an insured person in Jiangning District, the expenses incurred in Jiangning outpatient service will be 2,000 yuan as a whole, and individuals need to pay the deductible line of 1.200 yuan, and the rest can be reimbursed. And if you continue to see the clinic in the city, you have to pay for it at your own expense 1200 yuan. According to the New Deal, there is no need to pay the second sum 1200 yuan.
Medical insurance treatment is the most concerned content of the insured, especially the insured in the "five districts". Many large hospitals in the urban area can't swipe their cards for medical treatment normally, and the insured in the urban area also has the problem of inconvenient medical treatment. But none of this will be a problem in the future. The person in charge of the Medical Insurance Department of the Municipal Social Insurance Center told the reporter that there are currently 142 1 designated medical insurance units in the city, including 769 TCM research institutes and 652 retail pharmacies. After the implementation of municipal medical insurance co-ordination, all insured persons can buy medicines by swiping their cards at these designated medical insurance units.
The unified implementation of outpatient consultation and referral in the city.
The city's medical insurance will uniformly implement the first-visit referral system based on community health service institutions. Insured persons seek medical treatment in tertiary comprehensive medical institutions, and go through the referral procedures in the first-visit medical institutions according to regulations. The outpatient medical expenses incurred in the outpatient service are not included in the overall payment scope of outpatient service (except for emergency rescue). Outpatient co-ordination, chronic diseases, specific items and hospitalization policies of employees' medical insurance insured personnel are uniformly implemented according to municipal policies. For patients hospitalized with specific outpatient items, outpatient AIDS, outpatient psychosis, hemophilia and other registered diseases, hospitalization Qifubiaozhun is exempted.
In view of the lax control and irregular management of individual district-level medical insurance, the outpatient medical expenses for non-outpatient chronic diseases (outpatient specific items) and the medical expenses incurred by medical institutions not selected by me are not included in the scope of payment, and they shall bear the medical expenses themselves.
The medical insurance expenses paid by some insured persons are reduced.
According to the new regulations, the cumulative payment period of employee medical insurance (including deemed payment period) must be 25 years for men and 20 years for women, and the actual payment period shall not be less than 10 year. You can only enjoy medical insurance after retirement. If the payment period is insufficient, it will be paid in full in one lump sum according to the longest period that needs to be supplemented. The monthly supplementary standard is 9% of the payment base one month before my retirement. This reduces some expenses for insured employees who need to pay medical insurance, because the compensation standard last month was 9% of the average salary of employees in the previous year, which is definitely much higher than the payment base one month before my retirement.
Tong Jingjing, chief of the medical insurance department of the Municipal People's Social Security Bureau, explained: "If a retiree retires in June+10 this year, we will look at the retirement conditions. First look at whether the accumulated payment has reached 25 years for men and 20 years for women, and then look at the actual payment period. This document stipulates not less than one month, which is called transition. It depends on whether the individual has actually paid the payment period before. If it has been paid for one month, then this article will be considered satisfactory. "