What Is Medical Retirement?

Retired, retired, and retired employees of state agencies, groups, institutions, national ownership enterprises and county collectively-owned enterprises participating in social insurance enjoy medical insurance benefits (the medical expenses of retired employees' families are not included in the overall planning and are not reimbursed).

Retired employee medical insurance

Retired, retired, and retired employees of state agencies, groups, institutions, national ownership enterprises and county collectively-owned enterprises participating in social insurance enjoy medical insurance benefits (the medical expenses of retired employees' families are not included in the overall planning and are not reimbursed).

Chinese name

Retired employee medical insurance

According to

Social Security Law of the People's Republic of China

Condition

Legal retirement age

Treat

No longer paying basic medical insurance premiums after retirement

Core spirit

Enjoy basic medical insurance benefits in accordance with national regulations

Cost

7 yuan per month for retired and retired employees

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Medical units and medical staff of retired employees' medical insurance should adhere to the practice of civilized medicine, correct medical ethics, and assist medical insurance units to do a good job of medical management services for retired employees, so as to provide the right medicine and rational use of medicine.
Basic medical insurance benefits for urban unit employees and retirees (including individual owners and employees, freelancers, and migrant workers registered in this city).
All urban employers, including various types of enterprises, government agencies, social organizations, private non-enterprise units, and individual economic organizations, should apply for medical insurance for migrant workers who form labor relations with them.
Urban employees and retirees: All employers in cities and towns, including enterprises (state-owned enterprises, collective enterprises, joint-stock enterprises, foreign-invested enterprises, private enterprises), government agencies, public institutions, social organizations, private non-enterprise units and employees;
The insureds are treated out-patient first, and the medical expenses incurred in the out-patient treatment at the local designated hospital are settled by the medical guarantee, and the IC card is directly settled at the designated hospital. Medical expenses incurred in non-scheduled hospitals or out-patient clinics shall be paid in advance by the participating staff. Outpatient medical expenses and drug purchase expenses incurred by the insured person, whether locally or abroad, are not included in the overall fund for payment. If the outpatient treatment is ineffective, or the patient is in serious condition and needs to be hospitalized directly, the hospital registration procedure shall be completed in time.
The following information should be provided for admission registration:
1. The hospitalization card and related inspection report issued by the outpatient (emergency) physician;
2. Participants themselves medical insurance card and IC card;
3. The certificate issued by the unit where the insured person belongs.
Regarding patients who are in critical, acute or severe illness who need emergency rescue, regardless of the designated location or not, they should follow the principle of first-aid rescue treatment and bring relevant materials to the service hall of the agency to complete the admission registration procedures within 3 days. Insured employees who are hospitalized in a local designated hospital should submit their personal medical guarantee and IC card to the hospital's medical insurance department for identity verification and bookkeeping. Hospitalized employees with a card whose medical expenses are less than 38,000 yuan will be paid by the hospital (personal responsibility will be paid by the individual), and those above 38,000 yuan will be paid by the insured person in advance, and will be paid by the critical illness fund according to the prescribed proportion after discharge. Urban employees and retirees: Retirees who are relocated and incumbent employees on business trips and vacations who need to be hospitalized due to illness should choose a local designated hospital and contact the unit in time to register at the service hall of the agency.
Migrant workers to participate in basic medical insurance, the minimum payment standards, the overall fund payment ratio and the maximum payment limit, in accordance with the city's urban employee basic medical insurance standards. If a migrant worker is sick and needs to be hospitalized, he may choose a medical institution for hospitalization within the scope of the designated medical institutions for urban employee basic medical insurance in our city. Those who voluntarily request treatment for returning to their original place of residence may seek medical treatment at a designated medical institution of the local urban employee basic medical insurance upon approval of the medical insurance agency, and the regional medical insurance agency shall provide them with medical settlement services in a timely manner.
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In order to give full play to the transfer function of social insurance, to ensure that retired, retired, and retired employees have medical treatment, adhere to the principle of "guarante medical treatment and overcome waste," and adhere to the principle of "big illness and big cure, minor illness and little cure, and no illness and no cure". To promote the reform of the social insurance system, these measures are specifically formulated. The county retirement pension fund overall management committee has a medical management office. Before the establishment of the institution, the social insurance company will temporarily perform its duties; each township, town, and field shall set up a "three-in-one" medical insurance management team with party committees and governments, medical units, and medical insurance institutions. Responsible for the management of medical expenses, service, supervision, approval, and coordination to ensure the rational use of medical insurance expenses.
Retired, retired, and retired employees of state agencies, groups, institutions, national ownership enterprises and county collectively-owned enterprises participating in social insurance are eligible for medical insurance (the medical expenses of retired employees' families are not included in the overall planning and will not be reimbursed). Outpatient medical expenses are paid to everyone, and they are adjusted and controlled as they are paid. The standard is: retired cadres and retired workers who participated in revolutionary work before the founding of the People's Republic of China were 10 yuan per person per month; retired and retired employees were 7 yuan per person per month.
Hospitalization Procedures 1. All retired employees who enjoy social pooling medical insurance shall all seek medical treatment in the outpatient clinics of the hospitals prescribed by their medical insurance institutions. If the doctor diagnoses that they are not hospitalized, they must hold a medical certificate issued by the doctor, an inspection report, medical records and hospitalization. Notice, you can go to the medical insurance institution in your local area to be hospitalized.
2. Emergency hospitalized patients can be admitted to the hospital for rescue treatment first, and within 3 days with the emergency certificate to complete the admission approval procedures, otherwise the hospitalization drug fee will not be reimbursed.
3. Due to the serious condition, the local hospital is unable to treat, and those who need to be transferred to the county-level and above hospitals should be issued a transfer certificate by the resident physician. After the hospital director's signature and consent, the local medical insurance institution can review and agree. Referral treatment (emergency patients can be transferred for treatment first, but the transfer approval procedures must be completed within 5 days). Medical expenses for referral without prior approval for examination and treatment and hospitalization outside the hospital will not be reimbursed.
Reimbursement ratio 1. Retired cadres and retired employees who participated in the work before the founding of the People's Republic of China were hospitalized due to illnesses, third-stage silicosis patients, and second-level disabled soldiers.
2. Retired employees who have worked for more than 30 years will be reimbursed for 90% of their medical expenses.
3. Retired employees with a working age of 21 to 30 years will be reimbursed 85% of their medical expenses.
4. Retired employees with a working age of 15 to 21 years will be reimbursed 80% of their medical expenses.
5. For retired employees who have not worked for 15 years, their medical expenses will be reimbursed by 75%.
6. For retired employees, their medical expenses are reimbursed by 75%.
7. Inpatient bed charges are reimbursed for 60%. Regardless of the type of hospitalization, all inpatient bed charges will be charged. If the hospital does not collect the charges, the company will charge them.
Settlement of medical expenses 1. Before the patient is admitted to the hospital, the medical insurance institution shall pay the hospitalization fee based on the admission procedures. The maximum amount of each advance payment shall not exceed 300 yuan. If the advance payment for continued hospitalization is insufficient, the medical unit should issue a reminder notice, notify the medical insurance institution one day in advance to pay, and collect the self-paid part of the previous advance payment when repaying the advance payment, otherwise, the insurance institution refuses to accept Pay for continued hospitalization.
2. When the patient is discharged from the hospital, the medical unit and I shall notify the medical insurance institution one day before the discharge, and jointly settle the discharge medical drug payment according to the provisions of the three parties. If the discharge medical drug payment is not processed on time, the medical drug for the current hospitalization Fees are not reimbursed and expenses are deducted from retirement expenses.
3. When the patient is discharged from the hospital and needs to continue taking medicine because of the illness, the dosage of chronic disease should not exceed 7 to 9 days, and the acute disease should not exceed 3 to 5 days, otherwise it will be treated at his own expense.
Medical management 1. During the hospitalization period, retired employees should consciously abide by the medical management system, obey doctor's orders, and should not use any excuses to force medicines and make excessive additional requirements.
2. Medical units and medical staff should adhere to the principle of medical treatment, implement the right medicine, rationally use medicine, overcome waste of medicine, and serve the retired employees with enthusiasm.
3. The medical unit shall manage the archives of hospitalized medical records of retired employees, implement unit arrangement management, separate storage of hospitalization prescriptions, settle according to the actual situation, and actively assist the medical insurance department in supervision, review and management.
4. The staff of medical insurance institutions shall be loyal to their duties, handle affairs impartially, strictly manage, and do not hesitate to private affairs, and actively assist medical units to do a good job in providing hospitalization management services for retired employees.
5. For retired employees engaged in business and employed by the unit, the outpatient and hospitalization expenses during the period of business and employment shall be handled in accordance with the "Interim Measures". In case of violation, all medical expenses will be deducted from retirement expenses upon verification.
6. Medical expenses will not be reimbursed for those who go out for hospital treatment without permission.
Laid-off state-owned enterprise employees contribute to the country when they are laid off, and contribute to the reform when they are laid off. Now how can they make sacrifices after retirement, and hope that the country will soon turn the "happiness index" of retired employees of laid-off state-owned enterprises from ideal to reality.

Resolving difficulties Corporate retirees join medical insurance

Scope and target of implementation <br /> Retirees who meet one of the following conditions may be funded by the government to participate in the basic medical insurance for urban employees (uniformly participate in inpatient medical insurance).
Retirees from state-owned, county-level or above collectively-distressed enterprises who have received long-term pensions at social insurance agencies at all levels who closed, went bankrupt, disbanded, suspended production, stopped production, or ceased operations, and did not participate in urban employee basic medical insurance. The specific conditions for difficult enterprises are:
1. Serious insolvency, unable to pay off due debts;
2. Production has been suspended for more than one year due to operational difficulties;
3. The enterprise closed down or went bankrupt;
4. The enterprise has suffered serious losses, with a continuous loss of more than 2 years, an enterprise debt ratio of more than 80%, and in recent years, it has no hope of turning losses and is on the verge of bankruptcy;
5. The company has suspended production for more than one year due to operating difficulties, and its main business sales income or output value has decreased by more than 30% every year for the past three years, and has suffered large losses for two consecutive years.
Retirees who receive long-term pensions from social insurance agencies and were formerly state-owned enterprise employees. After leaving the state-owned enterprise through an agreement to dissolve labor relations, they have no reemployment and are in their personal capacity at various levels of social insurance agency service agencies (or employment agencies Service organization, talent market).
Level of funding and sources of funds < br Standards and sources of basic medical insurance premiums for urban employees. Those eligible for government-funded participation in the basic employee medical insurance for urban employees will pay a lump sum for 10 years based on the per capita medical expenses of retirees who participated in the basic employee medical insurance for urban employees in 2008. If a retiree is a retiree from a closed or bankrupt state-owned enterprise or a central and provincial state-owned collective enterprise in difficulty, the funds required for participation in the insurance shall be fully borne by the central and provincial finances; The funds required for personnel participation are borne by the city's urban employee basic medical insurance fund and the finance, each of which is borne by the provincial government, 25% by the provincial government, 25% by the city or district (county-owned enterprises are responsible by the district and county), and The employee basic medical insurance pool fund is responsible for 50% (Nan'ao County is responsible for the county employee medical insurance fund).
Municipal or district / county finances should provide subsidy funds for retirees to participate in insurance in 10 years. The Municipal Social Security Fund Administration will report the actual number of insured persons and funds in the city to the Municipal Finance Bureau, Municipal Labor and Social Security Bureau. Funds that should be borne shall be jointly notified by the Municipal Finance Bureau and the Municipal Labor and Social Security Bureau, and all levels of finance shall promptly transfer the subsidized funds of the urban and county finances to the special financial accounts for urban employees' basic medical insurance.
Medical insurance benefits (1) Those who are funded by the government to participate in the basic medical insurance for urban employees will all participate in inpatient medical insurance without establishing a personal account, basic medical insurance benefits and supplementary insurance benefits for high medical expenses.
(2) If the original employment has been covered by reference to the flexible employment personnel, the reduction procedures will be provided from the month of enrollment, and the balance of the personal account originally established can continue to be used, and the IC card fee cannot be refunded until it is used up.
Implementation step (2) Sign the agreement. The municipal government leaders in charge signed agreements with the district and county government leaders to clarify their responsibilities and ensure that tasks are completed on time.
(3) Organize implementation and assessment. Relevant units in various places should take effective measures to actively promote retirees from enterprises in need to participate in the basic medical insurance for urban employees. Strive to include retirees from difficult enterprises into the coverage of urban employees' basic medical insurance. The city government will check the completion of tasks in various places.
If there are temporary difficulties in financial solution, part of the savings from the basic living insurance of laid-off workers in cities and counties may be allocated to the medical insurance agency, and all retirees of eligible enterprises in difficulty shall be included in the scope of medical insurance. Can it be considered from the policy level that all retired employees of closed bankruptcy and difficult enterprises are included in the scope of urban residents' medical insurance. Separate the participation of retired employees in basic medical insurance from the participation of current employees in medical insurance to avoid mutual influence.