Interpretation of the new policy on employee medical insurance

Interpretation of the new policy on employee medical insurance: Starting from January 1, 2023, employee medical insurance will be unified into the basic medical insurance system for urban and rural residents nationwide. The insured persons will remain unchanged, and the benefits will be gradually unified. In the future, employee medical insurance will better serve employee groups.

Recently, the General Office of the State Council issued the "Opinions on Further Strengthening and Improving Basic Medical Insurance for Employees" (hereinafter referred to as the "Opinions"), clearly proposing new policies such as "gradually realizing national co-ordination of employee medical insurance." It is reported that this policy aims to optimize the management of employee medical insurance, improve the level of protection, and provide better medical services to employee groups. Specifically, from January 1, 2023, employee medical insurance will be integrated into the basic medical insurance system for urban and rural residents nationwide. Each region will establish a joint revenue and expenditure and risk compensation mechanism. The number of employees insured and the treatment standards will remain unchanged, but the The goal of gradually realizing unified benefits is to allow more employees to enjoy high-quality medical security. At the same time, the policy also requires strengthening the informatization construction of employee medical insurance to improve management efficiency, and encourages enterprises to participate in the operation and management of employee medical insurance. This new policy has brought many benefits to the majority of employees. Firstly, employee medical insurance will better serve the employee group and improve their ability and level to obtain medical insurance; secondly, the unified revenue and expenditure and risk compensation mechanism can standardize management and improve operational efficiency; finally, the implementation of the policy can promote the use of medical resources. Balanced allocation to reduce residents’ medical burden.

After the national coordination of employee medical insurance, how will the treatment standards be unified? According to the "Opinions", the basic medical security treatment standards for employee insured persons will remain unchanged, but unified treatment will gradually be achieved. Local governments can make appropriate adjustments based on existing standards to achieve better unification. Specific standards will be formulated by the state, governments at all levels and relevant departments based on actual conditions.

The new employee medical insurance policy is an important measure introduced by the state to improve the people's medical security level and promote the reform of the social security system. From January 1, 2023, employee medical insurance will be integrated into the basic medical insurance system for urban and rural residents across the country, and unified benefits will be gradually realized, which will provide better medical protection for the majority of employee groups. At the same time, in order to better realize the management and services of employee medical insurance, governments at all levels and relevant departments also need to actively participate and assist.

Legal basis:

Article 43 of the "Social Insurance Law of the People's Republic of China": Participants in the basic medical insurance for employees include current employees and retired employees and other personnel who participate in employee basic medical insurance in accordance with the law.