Yesterday, a distant uncle called me and asked me how to deal with the medical insurance that I had been working in Guangdong and wanted to return to my hometown in Hunan after retirement. Suddenly I felt that this was a good question, seemingly simple, but in fact quite complicated; It seems to be an individual case, but in fact it is common, similar to the employee medical insurance in other provinces before retirement, and there are many people who return to their hometowns after retirement. From the perspective of the insured employees, we have carefully considered and sorted out, and the suggestions are as follows.
1. Should I go through the procedures for medical insurance retirement in **?
The recommendations are on a case-by-case basis. There are generally two conditions for the payment period of employee medical insurance retirement:First, the cumulative payment period; The second is the actual number of years of payment in the local area. Taking the statutory retirement age in 2024 as an example, according to the regulations of Hunan Province, the cumulative payment period of insured persons shall not be less than 30 years for men and 25 years for women, of which the actual payment period within the province shall not be less than 11 years; According to the regulations of Shenzhen, the actual payment period for participating in Shenzhen employee medical insurance should be 10 years, and the cumulative payment period should be 25 years. If the relevant conditions are not met, it is necessary to continue to pay a single contribution according to the standard of treatment at the time of retirement, and the general unit will not contribute.
Therefore, such cases should be handled in a more personal interest. The first situation is that the cumulative payment or the actual payment period is relatively shortIf you need to pay a large amount in a single payment, this type may be more suitable for giving up the employee medical insurance and participating in the resident medical insurance of the actual place of residence. In fact, the difference between the treatment of participating in employee medical insurance and participating in resident medical insurance is not as big as imagined, of course, there is a problem of risk and choice. Exceptions: It is also necessary to consider that there will be a certain amount of inclusion in the personal account after retirement, which should be comprehensively weighed. The second situation is that the place of employment or former place of employment has met or is about to meet the conditions for medical insurance retirementAt this time, medical insurance retirement should be handled in areas where there is no single payment or less single payment, and the single payment of employee medical insurance is still a heavy burden on individuals.
2. What should I do if I live in a different place after going through the medical insurance retirement procedures?
The suggestion is to apply for the filing of retirees or long-term residents in other places. According to the national policy, there are two main categories of people who seek medical treatment in other places: long-term residents in other places and those who go out for medical treatment temporarily. Long-term residents in other places can be divided into retirees who have been resettled in other places (their household registration has been transferred), long-term residents in other places (long-term residents who have not been transferred to their household registration) and permanent staff who are resident in other places, which are mainly related to the valid certificates that should be provided.
So,What is the medical insurance treatment for long-term residents in other places? According to the relevant regulations, long-term residents in other places do not need to reduce the reimbursement ratio for medical treatment in other places, and maintain the same medical treatment payment ratio as in the insured place. That is, after the filing of long-term residence in other places, the implementation of the directory of medical treatment (drugs, medical service items and medical consumables, etc.), the policy of the place of insurance (the starting line, payment ratio, the maximum limit, the scope of outpatient chronic diseases, etc.), and the general medical institutions have realized the direct online settlement of remote hospitalization, and the individual only needs to pay the self-responsible part, and the rest will be cleared by the medical insurance department.
The procedure for long-term residence in a different place is also very simpleIt can be handled on the national medical insurance service platform and the relevant online service platform in the place of insurance, which is simple and fast, and many places have also adopted the commitment system for filing (that is, promising to live in a different place for a long time, without the need for relevant certificates in other places), and the record of long-term residence in a different place is a record and valid for a long time.
It is worth noting that the current employee medical insurance has an outpatient co-ordination policy, but the remote networked direct settlement of outpatient co-ordination, including the remote networked direct settlement system for outpatient chronic diseases, is not yet smooth. In many areas, only a few medical institutions have opened outpatient remote network settlement, outpatient chronic diseases have only opened a few diseases, and pharmacies cannot purchase drugs for the time being. These problems mainly involve a huge amount of data and cumbersome interface calls and policy coordination, etc., inpatient remote network settlement is also after years of efforts to have today's convenience, the relevant system basic conditions of outpatient clinics are worse, the medical insurance department is working hard to promote, over time will be fully connected, more convenient.
3. Why do we need to have a relevant number of years?
Explain why there is a requirement for the number of years of payment, because according to the policy of employee medical insurance, no more contributions will be made after retirement, so everyone must be required to pay the share of contributions before retirement, so as to ensure the safe and sustainable operation of the first place; Why should there be a requirement for the number of years to be paid locally, because the current pool of medical insurance cannot be used interchangeably, that is, the ** levied by Guangdong Province is in the pool of Guangdong Province, and the ** levied by Hunan Province belongs to Hunan Province. However, medical insurance has always adhered to the people-centered development idea, only need to file online, the reimbursement ratio remains unchanged, and the insured place is paid first, which not only solves the outstanding contradictions, but also facilitates the masses to seek medical treatment.
* |Medical road peers medicine you share.
Edit |Yang Zixuan, Zhang Wenqing.
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