As a policy guarantee for in-service and retired employees to enjoy basic medical treatment, medical insurance for urban employees has reduced the economic burden of the insured to a large extent, and also provided them with a relatively complete treatment mechanism, including but not limited to basic medical security such as general emergency outpatient reimbursement, hospitalization reimbursement, and serious illness assistance. Referring to the "2022 National Statistical Communiqué on the Development of Medical Security" released by the National Health Insurance Administration, the data disclosed in it shows that by the end of 2022, the total number of 2024 travel guides insured in China's basic medical insurance for urban employees has reached 362.43 million, an increase of 8.13 million compared with the end of 2021, with a growth rate of 23%。
Two data worth mentioning are that the number of insured employees on the job is 266.04 million, an increase of 19%；The number of retired employees enjoying lifelong medical security was 96.39 million, an increase of 3 compared with 20214%。In addition, with the improvement of the employee medical security system and the reform of the outpatient mutual aid mechanism, the level of medical security treatment enjoyed by the insured employees in ordinary emergency outpatient services, chronic diseases, hospitalization, etc. has been further improved, and the enthusiasm of employees to participate in the insurance has increased significantly.
Lifetime medical insurance treatment for retired employeesIt is obviously different from the basic medical insurance for urban and rural residents that retired employees who have reached the statutory retirement age and have reached the minimum number of years stipulated by the local medical insurance department can enjoy lifelong medical security treatment without paying any more. The so-called lifelong medical insurance treatment, that is, a special medical benefit "exclusive" for the majority of retired insured employees, even if the balance of the personal account is 0, you can also enjoy the treatment of ordinary emergency outpatient services, chronic diseases, hospitalization reimbursement, etc., the key point is that there is no need to participate in the insurance and pay the premium.
As we all know, employees who have reached the statutory retirement age and have paid basic pension insurance for 15 years can apply for basic pension on a monthly basis after going through the retirement procedures. Similar to the basic pension insurance system, the current employee medical insurance system stipulates that insured employees who meet the corresponding conditions can also apply for "medical insurance retirement" and then enjoy medical insurance lifelong benefits.
So the question is, for retired employees who want to enjoy lifelong medical insurance benefits, how long is the minimum insurance payment period? For this problem, some regions have new regulations in 2024.
From 2024, the minimum payment year for medical insurance will be limited
On January 19, 2021, the National Health Insurance Administration issued the "Opinions on the Establishment of a Medical Security Treatment List System", requiring all co-ordinating regions to gradually standardize the policy of payment period; On June 16, 2021, the National Health Insurance Administration issued the "Three-Year Action Plan for Implementing the Medical Security Treatment List System (2021-2023)", further clarifying that it will take three years to implement the medical security treatment list system, and realize the standardization and unification of the medical security system setting, policy standards, and payment scope nationwide. It is understood that since entering 2024, a series of medical insurance policy adjustments have been made in some regions, such as announcing the upper and lower limits of the social security payment base for the new year, clarifying the new inclusion rules for medical insurance personal accounts, and readjusting the verification standards for medical insurance payment years. Below, we will introduce you to the latest policies implemented in some regions.
Tianjin: From 2024, the medical insurance payment period should be no less than 25 years for male employees and no less than 20 years for female employeesA few days ago, the Tianjin Medical Insurance Bureau issued the "Notice on Improving the Measures for the Verification of the Payment Period of Basic Medical Insurance for Employees", which clarifies that from January 1, 2024, retired insured employees must meet the following conditions if they want to enjoy lifelong medical insurance treatment:Insured personsofThe number of years of medical insurance payment for employees shall not be less than 25 years for male employees and not less than 20 years for female employeesTianjin'sThe actual payment period should not be less than 5 years.
It is worth mentioning that the payment period of employee medical insurance includes the actual payment period and the deemed payment period, and the basic rules for the approval of the payment period are clarified in the above-mentioned "Notice on Improving the Measures for the Verification of the Payment Period of Basic Medical Insurance for Employees".
Shenyang: From January 1, 2024, the minimum payment period for male employees will be increased to 30 years year by yearOn December 26, 2023, the Shenyang Medical Insurance Bureau issued the "Notice on Adjusting the Minimum Payment Period for Basic Medical Insurance for Urban Employees in Shenyang", which clarifies that from January 1, 2024, the minimum payment period (including the deemed payment period and the actual payment period) for male insured persons who have reached the statutory retirement age will be gradually adjusted from 25 years for men to 30 years for men. The adjustment method will be increased by one year every year, and it will be adjusted to 30 years until 2028.
Hunan: In 2024, the actual payment period within the province shall not be less than 11 yearsIn December 2022, Hunan Province issued the "Implementation Measures for Basic Medical Insurance for Employees in Hunan Province", which clarified that the cumulative payment period (including the deemed payment period and the actual payment period) of insured persons shall not be less than 30 years for men and 25 years for women. In addition, Hunan requires that the minimum actual payment period within the province be increased by one year every year after January 1, 2023, that is, in 2024, if retired insured employees in Hunan want to enjoy lifelong medical insurance treatment, in addition to meeting the condition of not less than 30 years for men and 25 years for women, the minimum actual payment period in Hunan Province should not be less than 11 years.
If I reach the statutory retirement age and am less than the minimum payment period, can I make up the payment?
Through the above introduction, it is not difficult for us to draw a conclusion, that is, as long as the minimum payment period of the insured employees after retirement meets the standards stipulated by the local medical insurance department, they can enjoy lifelong medical security treatment without paying any more. So, for retirees who have reached the statutory retirement age but have insufficient years of contributions, is it allowed to make supplementary contributions? There are also regulations on this issue.
For example, the Chongqing Medical Insurance Bureau stipulates that for payers who have not paid the full number of years of medical insurance and have begun to enjoy pension benefits, they can choose to pay the remaining years of medical insurance in one lump sum, that is, make up for a few years of difference; Another example is Beijing's policy, which stipulates that for those who reach retirement age, social pension insurance is enough for 15 years, medical treatment for women is less than 20 years, and men are less than 25 years, they can choose to make a one-time supplementary payment. Nationwide requirements for the number of years of medical insurance contributions
For retired employees who want to enjoy lifelong medical insurance benefits, there are certain differences in the minimum payment period for employee medical insurance in different provinces and cities. Moreover, many regions have also made it clear that there must be an actual payment period in the local area, such as the above-mentioned Tianjin and Hunan, which require that the actual payment period within the local or provincial scope must meet the corresponding standards at the same time.
In addition, it should also be emphasized that employee medical insurance is different from pension, which generally requires cumulative payment periods, and even if there is a break in the middle of the payment, it will not affect the cumulative payment period. Once the payment of employee medical insurance is suspended, it is likely to lead to the interruption of the continuous payment period. For example, in Ankang City, Shaanxi Province, the local government has stipulated the requirement of continuous payment period, and if the payment is interrupted, the payment period will start to be calculated again. Therefore, for insured employees in different regions, it is necessary to understand the local policy requirements in detail, after all, if you want to enjoy lifelong medical insurance treatment in the place of retirement, you still have to refer to local regulations.
Conclusion
In general, for the adjustment of the minimum payment period of employee medical insurance, many regions will give more consideration to various factors such as continuous payment, actual payment within the province or city, and deemed payment period, and no longer only take the payment period as the basis for retired employees to enjoy lifelong medical insurance treatment. From this point of view, these adjustments put forward higher requirements for insured employees, if you want to enjoy the basic old-age security treatment after retirement, but also enjoy lifelong medical security, then I am afraid that the number of years of social security payment will need to be further extended. Therefore, for this aspect, insured employees need to have a clear understanding.