The employee medical insurance outpatient (emergency) clinic payment limit is increased

Our reporter (reporter Huang Jiangao) learned from the press conference held yesterday that the \”Implementation Measures for Improving the Outpatient Mutual Aid Security System for Employees\’ Basic Medical Insurance\” issued by this city is in accordance with the According to the principle of step-by-step implementation, starting from January 1 this year, relevant policies such as reforming the personal account accounting method, increasing the maximum payment limit for outpatient (emergency) clinics, and dynamically adjusting the minimum payment standards for outpatient (emergency) clinics have been implemented. From January to May this year, 21.96 million people visited general outpatient clinics under employee medical insurance in this city, and the amount paid by the medical insurance fund was 4.5 billion yuan. The personal account family mutual aid function will be officially implemented from July 1.

Gao Lianhuan, deputy director of the Municipal Medical Insurance Bureau, introduced that the \”Implementation Measures\” issued this time have many new policies, new measures, and new reforms, and overall show three major characteristics: more affordable benefits. Through the reform, the maximum payment limit for employee medical insurance outpatient (emergency) clinics has been significantly increased by 1,500 yuan to 9,000 yuan, benefiting more than 6.3 million insured persons in the city, and effectively alleviating the problem of insufficient outpatient medical insurance for some insured persons with chronic diseases. problems; at the same time, the outpatient deductible payment standard is moderately tilted towards retired groups, further reducing the burden of medical treatment.

The service is more convenient for the people. Through the reform, family members (the insured and his/her spouse, parents, and children) can use personal accounts together. In terms of reimbursement for drug purchases, prescription circulation is supported. Insured persons who purchase drugs at pharmacies can enjoy reimbursement according to the reimbursement policy of the prescription circulation hospital, further improving the service experience.

More standardized management. Through the reform, personal accounts have been managed in a closed manner, and the use has been expanded from the original limit of medical treatment for insured persons to the purchase of medical equipment, consumables and other medical expenses borne by individuals, and can also be used by family members. The scope of use has become more clearly defined, and management more standardized.

Source: Tonight\’s Daily