国务院新闻办公室1日举行国务院政策例行吹风会，介绍《关于健全基本医疗保险参保长效机制的指导意见》有关情况。国家医疗保障局副局长黄华波在会上表示，《指导意见》不仅延续了职工医保个人账户共济政策，还进一步优化了共济政策，放宽了共济范围。
黄华波介绍，《指导意见》中的“两个放宽”是重要亮点。首先，放宽户籍限制，让异地就业、异地务工、异地居住和上学的群众和孩子们更好就地参保，从而更好就地就近就医，购药时方便医保报销。近年来，国家医保局积极推动这项工作，绝大部分城市已经取消了参保的户籍限制，群众持居住证或满足一定年限后即可在常住地参保，这一政策已经普遍实现。目前，只有极少数的超大城市还未放开户籍限制，此次《指导意见》全面落实党的二十届三中全会提出的健全灵活就业人员、农民工、新就业形态人员的社保制度，全面取消在就业地参保的户籍限制，积极回应群众关切，尤其是聚焦中小学生儿童和灵活就业人员，提出取消户籍限制，进一步助力新型城镇化取得新的成效。
其次，放宽个人账户共济范围。职工医保个人账户共济是指个人账户里的钱可以供家人使用，概括为“家庭共济能参保，帮助老人帮助小”。《指导意见》不仅延续了职工医保个人账户共济政策，还进一步优化了共济政策，放宽了共济范围。一方面共济的范围扩大到了近亲属，即配偶、父母、子女、兄弟姐妹、祖父母、外祖父母、孙子女、外孙子女等，如果这些近亲属是参保人，在报销医疗费用时，可使用共济人的个人账户进行结算。另一方面，共济地域进一步扩大，计划分两步走，第一步是今年年底之前力争共济范围扩大到省内的跨统筹地区使用，第二步就是明年加快推进跨省共济。要强调的是，家庭共济主要是共济职工个人账户里的钱，不包括统筹基金部分。
这一系列措施的出台，将进一步完善我国基本医疗保险参保长效机制，提高医保政策的覆盖面和便捷性，为广大参保人员提供更加优质的医疗服务和保障。
英语如下：
News Title: “New Health Insurance Policy: Expanding Mutual Aid Scope to Support New Urbanization”
Keywords: Health Insurance Mutual Aid, Relaxation of Restrictions, Optimization of Policy
News Content:
The State Council Information Office held a regular policy briefing on the first day of the year to introduce the situation concerning the “Guiding Opinions on Establishing a Long-term Mechanism for the Participation in Basic Medical Insurance,” which was announced by the State Council. At the meeting, Huang Huabo, Deputy Director of the National Medical Insurance Administration, stated that the “Guiding Opinions” not only continued the policy of mutual aid in individual accounts for employees’ medical insurance but also further optimized the mutual aid policy and relaxed the scope of mutual aid.
Huang Huabo explained that the “two relaxations” in the “Guiding Opinions” are a significant highlight. First, the policy relaxed restrictions based on residency, allowing people who work or live abroad, including children, to better participate in insurance where they are, thus facilitating local and convenient medical treatment and the purchase of medications for reimbursement by the medical insurance. Over the past few years, the National Medical Insurance Administration has actively promoted this work, and in the vast majority of cities, the residency restrictions for participation in insurance have been eliminated. Citizens can participate in insurance in their places of residence with a residence certificate or after a certain period of residency. This policy has been widely implemented. At present, only a very few megacities have not yet relaxed residency restrictions. The “Guiding Opinions” fully implement the proposal made at the Third Plenary Session of the 20th National Congress of the Communist Party of China to establish a social security system for flexible workers, migrant workers, and new types of employment, completely eliminating residency restrictions for participating in insurance in employment locations, and actively responding to public concerns. Specifically, the focus is on primary and secondary school students and flexible workers, proposing to eliminate residency restrictions, further supporting the new urbanization to achieve new results.
Secondly, the scope of mutual aid for individual accounts has been expanded. The mutual aid for individual accounts in employees’ medical insurance refers to the use of funds in personal accounts for family members, summarized as “Family Mutual Aid for Participation and Supporting the Elderly and the Young.” The “Guiding Opinions” not only continued the policy of mutual aid for employees’ medical insurance but also further optimized the policy and relaxed the scope of mutual aid. On the one hand, the scope of mutual aid has been expanded to close relatives, including spouses, parents, children, siblings, grandparents, grandmothers, grandchildren, and grandsons, if these close relatives are insured, they can use the funds in the personal accounts of the mutual aid person to settle medical expenses. On the other hand, the geographical scope of mutual aid has also been expanded, with a plan to move forward in two steps. The first step is to strive to expand the scope of mutual aid to cross-coordinated areas within the province by the end of this year, and the second step is to accelerate cross-provincial mutual aid next year. It should be emphasized that family mutual aid mainly involves the funds in the individual accounts of employees, not including the pooling fund portion.
The introduction of these measures will further improve the long-term mechanism for the participation in basic medical insurance in China, increase the coverage and convenience of medical insurance policies, and provide high-quality medical services and protection for a wide range of insured individuals.
【来源】http://www.chinanews.com/life/2024/08-01/10261639.shtml
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