Since April, there have been changes in the health insurance policy of Texas | setting a three-month waiting period for benefits to be enjoyed and adjusting the minimum payment period…

2022-06-08 0 By

Recently, shandong Provincial Medical Insurance Bureau and other three departments jointly issued the Notice on Further Standardizing the Payment and treatment payment of Basic medical insurance (Shandong Medical Insurance Fa (2021) No. 54), which was forwarded and implemented by the Medical insurance department of Dezhou City, and clarified related issues in the implementation process.Starting from April 1, 2022, Dezhou City will implement policies and regulations on insurance payment and treatment payment in the whole province.The regulations cover many aspects, such as the payment and treatment connection of employees’ medical insurance, the centralized payment and treatment waiting period for residents’ medical insurance, the minimum payment period for employees’ medical insurance, and the transfer and continuation of employees’ medical insurance relationship.Unite for the first time join protect with pay to enjoy policy unit of choose and employ persons ought to deal with worker primary medical treatment insurance to join according to the country regulation keep register, join keep worker since the second month of capture cost, enjoy treatment of insurance of worker primary medical treatment.No worker individual and industrial and commercial door, in the unit of choose and employ persons to participate in worker is basic medical treatment insurance for part-time workers and other personnel of flexible obtain employment (hereinafter generally referred to as the personnel of flexible obtain employment), to participate in the employee basic medical insurance, without being limited by the coverage to the household registration, since the protect capture following enjoy treatment of insurance of worker is basic medical treatment.If the insured unit suspends the payment of basic medical insurance premium for any reason, it shall suspend the payment of basic medical insurance benefits to its employees from the month following the interruption of payment;Join protect the unit from fill neat owe fee and fine for delaying payment the second month since, restore the treatment of insurance of primary medical treatment of its worker.Fill capture to interrupt the cost during capture cost, calculate capture cost of primary medical treatment insurance only fixed number of year, owe the medical treatment charge that happens during cost does not bring medical treatment insurance to plan as a whole fund pays.The suspension of payment of flexible employment personnel shall be implemented by referring to this provision. If the suspension of payment exceeds 3 months, a waiting period of 3 months shall be set for the benefits to be enjoyed (including the month of payment, the same below).Standard worker primary medical treatment is sure concern transfer continue and pay enjoy policy join to protect worker province to cross as a whole area transfer continue primary medical treatment is sure concern, pay of primary medical treatment is sure to enjoy the end of the month that turns out ground expends cost.Join protect worker rotation to go out ground to deal with reduce member that month rise, concern of insurance of continuation of primary medical treatment inside 3 months and fill capture interrupt pay cost period charge, enjoy treatment of insurance of worker medical treatment since that month that protect capture cost, turn into ground to pay its to fill the medical treatment charge that happens during capture cost by the regulation;Exceed 3 months continue concern of insurance of primary medical treatment and join protect pay cost, enjoy treatment of insurance of worker primary medical treatment since join the second month that keep pay cost, fill capture to interrupt pay cost period charge, calculate capture of cost of insurance of primary medical treatment to expend only fixed number of year, the medical treatment charge that produces during owe cost does not bring medical treatment insurance to plan as a whole fund pays.Personnel of flexible obtain employment is crossed inside province as a whole area transfer continuance primary medical treatment is sure concern, carry out according to above regulation.Centralized payment period of residents’ basic medical insurance Starting from 2022, the centralized payment period of residents’ basic medical insurance will be implemented in accordance with the Implementation Opinions on The Establishment of medical Security Payment List System (Shandong Medical Insurance Fa (2021) No. 43), and will be uniformly from September to December each year.Residents who pay premiums on time during the period of centralized payment shall enjoy basic medical insurance benefits from January 1 of the following year.For those who pay after January 1 of the following year, a waiting period of 3 months will be set up after the individual payment.If the current policies of each municipality are inconsistent with this provision, the implementation can be postponed for one year.There is no waiting period for low-income people, such as those receiving subsistence allowances and people living in extreme poverty, and those returning to poverty and becoming poor, to participate in basic medical insurance for residents.Newborn executes be born join protect policy newborn to deal with insurance of primary medical treatment to join to protect formalities and expend inside 6 months since the day that be born, enjoy treatment of insurance of primary medical treatment since the day that be born;For more than 6 months, the treatment of insurance of primary medical treatment shall be enjoyed since the second month of payment;More than 12 months, according to the treatment of ordinary residents pay cost and enjoy the corresponding policy provisions The unified provincial lowermost capture to expend fixed number of year of insurance of primary medical treatment Ginseng protect a worker to enjoy treatment of insurance of primary medical treatment retiree cumulative lowermost capture to expend fixed number of year according to the list on establishing a health care treatment system of the implementation opinions “(health care hair [2021] no. 43) regulations,30 years for male employees and 25 years for female employees, which does not reach the required number of years, and the transition will be in place by the end of 2025.The cumulative number of years of payment includes the actual number of years of payment of basic medical insurance and shall be regarded as the number of years of payment.Be regarded as capture expends fixed number of year specific affirm to refer to insurance of endowment insurance, medical treatment relevant policy is decided.Reach legal emeritus age, did not reach worker primary medical treatment insurance minimum pay cost fixed number of year, can after one-time pay cost by the regulation, enjoy treatment of primary medical treatment of retiree;Also can continue to pay cost by month to lowest capture cost fixed number of year, enjoy treatment of primary medical insurance by on-the-job personnel during.Cancellation of the limit on the actual number of years of payment of basic medical insurance for transferred and continued employees within the province.Join to protect concern of insurance of worker primary medical treatment to turn into my province from outside the province, continue to carry out to turn into the regulation of fixed number of year of ground actual capture expends.Disclaimer: The copyright of this article belongs to the original author, if there is a source error or infringement of your legitimate rights and interests, you can contact us through email or wechat, we will deal with it in time.Email address: jpbl@jp.jiupainews.com;Wechat id: Jiupai6688 (Note to add and withdraw)