Three departments: the medical expenses related to prenatal examinations that meet the requirements incurred by insured residents in outpatient clinics will be included in outpatient insurance coverage.

On August 26, the National Healthcare Security Administration, Ministry of Finance, and State Taxation Administration issued a notice on the work related to the basic medical insurance for urban and rural residents in 2024. The notice mentioned enhancing the accurate guarantee ability of critical illness insurance, with the principle that the deductible for critical illness insurance should generally not exceed the previous year's per capita disposable income of urban and rural residents in the local area. The maximum payment limit for residents' medical insurance combined with critical illness insurance should generally reach around 6 times the previous year's per capita disposable income of urban and rural residents in the local area, and the reimbursement ratio should be tilted towards high medical expenses. The notice also stated that eligible medical expenses for prenatal examinations in outpatient settings should be included in outpatient coverage, with access to general outpatient benefits, and the level of coverage for hospital childbirth and maternity medical expenses should be reasonably increased to further reduce the burden of maternity medical expenses on insured residents. The notice also mentioned that in 2024, levels of government will continue to increase subsidies for residents' medical insurance premiums, while the increase in individual contributions will be moderately reduced. Financial subsidies and individual contribution standards will increase by 30 yuan and 20 yuan respectively compared to the previous year, with each person receiving no less than 670 yuan and 400 yuan per year. This is the first time since 2016 that the new individual contribution standard is lower than the financial subsidy standard. The notice specifies that the central government will continue to provide tiered subsidies to localities according to regulations, with the western and central regions receiving subsidies at 80% and 60% of the per capita financial subsidy standard, respectively, and the eastern regions providing subsidies to provinces at certain proportions. For residents participating in local residents' medical insurance using a residence permit, governments at all levels should provide subsidies at the same standard as local residents. (source: text in original language)Smooth operation.Five How to improve the sense of insurance participation by including village clinics in the designated medical insurance management? Village clinics, as the most basic medical institutions, are the foundation of the rural medical and health service system, the first stop for rural residents to seek medical treatment, and the "last mile" to provide medical insurance services. Including village clinics in the designated medical insurance management is of great significance in continually meeting the growing medical insurance needs of rural residents and improving the accessibility of treatment and medication for common and prevalent diseases. Recently, the National Medical Insurance Administration, together with the National Health Commission, issued a notice on accelerating the inclusion of village clinics in designated medical insurance management, guiding localities to accelerate the inclusion of village clinics in the medical insurance designated management, ensuring that eligible village clinics are included in the medical insurance settlement scope by the end of 2024. At least one village clinic in each administrative village with multiple village clinics should be included in the designated medical insurance management to ensure that medical insurance services are accessible to every village, making it convenient for residents to seek treatment and purchase medication locally. Support village doctors in providing family doctor contract services, conducting insurance participation outreach, preventive health care, chronic disease management, traditional Chinese medicine diagnosis and treatment services, etc. As of April 2024, there are 580,000 operating village clinics nationwide, of which 100,000 are included in the separate designated medical insurance scope, and 320,000 village clinics adopt the "rural integration" management model, with medical insurance reimbursement through township health centers. Over 72% of village clinics nationwide have been included in the medical insurance payment scope. Six Can the individual account of employee medical insurance be used to assist family members participating in the urban and rural residents medical insurance? "In family solidarity, we can participate in insurance and help the elderly and children." The recent "Guiding Opinions on Improving the Long-term Mechanism for Basic Medical Insurance Participation" issued by the General Office of the State Council specifies that the scope of sharing from the individual account of employee medical insurance can be expanded to immediate family members. Immediate family members refer to spouses, parents, children, siblings, grandparents, grandchildren, great-grandparents, great-grandchildren, according to the Civil Code. The individual account of employee medical insurance can be used to pay for the personal contributions of immediate family members to participate in the basic medical insurance. Immediate family members participating in basic medical insurance can also use the personal account of the employee medical insurance participant to settle medical expenses when reimbursing medical expenses. The notice requires that the policy of using the employee medical insurance individual account for family sharing be fully implemented. The National Medical Insurance Administration will actively promote further expansion of the sharing scope, striving to achieve intra-provincial sharing in all provinces by the end of this year and accelerate inter-provincial sharing next year. In order to effectively implement the organization, the notice requires all relevant departments in various regions to strengthen organizational leadership, improve work mechanisms, assign work responsibilities, enhance departmental coordination, strengthen risk awareness, manage funds, carry out propaganda, interpret policies, promote the implementation of institutional policies in detail, and effectively safeguard the medical insurance rights and interests of the people. This article is compiled from the National Medical Insurance Administration, GMTEight Editor: Chen Wenfang.