When it comes to retirement, many people will think of pension at the first time, after all, the level of pension is directly related to the quality of basic life in later life. In fact, according to the current social security system, many people often ignore a very important issue after retirement at the age of 60, that is, lifelong medical security benefits. Similar to the employee pension insurance system, the basic employee pension insurance paid by the insured also needs to be "retired" in order to enjoy basic medical security treatment for life. Therefore, from this point of view, it is not enough for insured workers aged 60 and above to simply complete the retirement procedures of pension insurance, after all, pension treatment cannot replace medical security.It is no exaggeration to say that for the insured employees who have only gone through the old-age retirement procedures and have not gone through the medical insurance retirement, the situation that they cannot enjoy lifelong medical insurance treatment in accordance with the policy is like a "time bomb", which may bring you trouble and even a heavy financial burden when the retired employees need medical security the most.
What are the benefits of lifelong medical insurance for retired employees? According to the provisions of the current basic medical insurance system for employees, male and female employees who have reached the statutory retirement age also need to meet the local policy requirements of the "minimum payment period of employee medical insurance" before they can apply for medical insurance retirement and then enjoy lifelong medical insurance treatment. For example, the Tianjin Medical Insurance Bureau stipulates that from January 1, 2024, if retired insured employees want to enjoy lifelong medical insurance benefits, they must meet the following conditions: the number of years of medical insurance payment for insured personnel should be no less than 25 years for male employees and no less than 20 years for female employees, and the actual payment period in Tianjin should not be less than 5 years.
Generally speaking, the lifelong medical security benefits enjoyed by retired employees have the following benefits:There is no need to participate in the insurance and pay premiums
As we all know, in-service employees need to pay monthly contributions to participate in basic medical insurance with their units. According to the national policy, the payment amount of an individual is generally 2% of the selected payment base, and this part of the payment amount is fully included in the personal account, which can be used for reimbursement of ordinary outpatient and emergency services or swiping the social security card to purchase drugs directly in pharmacies. Retirees who enjoy lifelong medical insurance benefits do not need to participate in insurance and pay premiums, and they can also enjoy various medical insurance benefits.
Co-ordination**Credited to personal accounts according to the fixed amount every month
Before the reform of the outpatient mutual aid guarantee mechanism of employee medical insurance, the amount included in the personal account of retirees' medical insurance was generally directly linked to the level of personal basic pension; After the reform, many places adopted the method of inclusion according to the quota. For example, in Chongqing, from January 1, 2024, the standards for the inclusion of personal medical insurance accounts for retired employees are: retirees under the age of 70 will be allocated 105 yuan per month, and retirees over 70 years old will be allocated 115 yuan per month.
The level of guaranteed benefits is relatively highIn terms of outpatient reimbursement ratios:For example, the outpatient reimbursement ratio of retired employees enjoying lifelong medical insurance in Chongqing is up to 70%, which is 10% higher than that of in-service employees;
The annual reimbursement limit for general outpatient clinics is higherFor retirees who enjoy lifelong medical insurance benefits, the reimbursement limit for general outpatient services is higher in a year. For example, Chongqing stipulates that the annual reimbursement limit for ordinary outpatient clinics for retirees is 4,000 yuan, which is 1,000 yuan higher than that of in-service insured employees;
Hospitalization reimbursement rates are higherFor example, Beijing stipulates that the hospitalization reimbursement ratio for in-service employees is up to 85%, while the hospitalization reimbursement ratio for retired employees is more than 90%, up to 991%, and the maximum line for hospitalization is 500,000 yuan. To sum up, in fact, it is a sentence that the medical security treatment will be tilted towards retirees who enjoy lifelong medical insurance benefits.
How to handle the medical insurance retirement procedures? As mentioned above, there are two prerequisites for insured employees to go through the procedures for medical insurance retirement:
Reach the statutory retirement age, that is, male employees at least 60 years old, female employees at least 50 years old, and female cadres at least 55 years old; Meet the minimum payment period stipulated by the local health insurance department.
It is reported that at present, the minimum payment period for employee medical insurance varies from place to place, with some requiring at least 20 years and others requiring a minimum of 25 years. In addition, the requirements for male and female employees are different.
For those who meet these two conditions at the same time, they can apply for medical insurance retirement. In general, the following 4 aspects of information are required:
The original and photocopy of the insured's ID card or citizen card.
If you entrust another person to handle the application, you must also provide the ID card of the agent.
If there is a medical insurance deemed payment period or transfer outside the province, please provide relevant dossiers.
When applying, fill in the "Application Form for Deferred Payment of Medical Insurance Retirement".
How to deal with the insufficient number of years of medical insurance payment? Apply to the local medical insurance management department, and then make a one-time payment up to the minimum payment period stipulated by the local government; 2024 Travel Guide Continue to pay basic medical insurance premiums on a monthly basis until the required minimum payment period is met, and then apply for medical insurance retirement;
No more supplementary payment, give up directly, and then participate in urban and rural residents' medical insurance, enjoy the treatment of resident medical insurance. It should be pointed out that like the second way of processing, it is actually necessary to apply to the social security department for deferred payment, after all, the age has reached the statutory retirement conditions. As for giving up employee medical insurance and choosing resident medical insurance, the author does not recommend this, because there is still a certain gap between the level of protection between the two.
ConclusionIn general, applying for retirement after the age of 60 does not mean real retirement, and if the medical insurance payment period does not meet the policy requirements, you cannot enjoy medical insurance after retirement. Therefore, only when you enjoy lifelong medical security and basic pension treatment at the same time, can you officially start your retirement life!
The author believes that it is very necessary to remind the majority of insured employees in front of the screen that we must pay more attention to and understand the local social security policy, and keep abreast of the latest developments in terms of pension and medical treatment.