职工医保个人账户跨省共济有何新变化

Core Viewpoint - The National Healthcare Security Administration and the Ministry of Finance have issued a notice to enhance the cross-provincial pooling of employee basic medical insurance personal accounts, expanding the scope of shared usage among family members. Group 1: Family Pooling of Medical Insurance Accounts - The employee medical insurance system in China has combined social pooling and personal accounts since its establishment in 1998, allowing personal account funds to cover individual medical expenses [1] - In 2021, the scope of family pooling was expanded to include spouses, parents, and children, and by July 2024, it will further include "close relatives" as defined by the Civil Code [1] Group 2: Cross-Provincial Pooling Implementation - The nationwide implementation of cross-provincial pooling was officially launched on December 2, 2024, in Suzhou, Jiangsu, allowing insured individuals to transfer funds to close relatives who are also insured [2] - The new notice introduces management requirements for pooling relationships, allowing voluntary establishment or dissolution of these relationships, which will automatically end with changes in the insured person's status [3] Group 3: Regulations on Pooling Funds - The notice specifies that personal account funds can be used for medical expenses incurred by close relatives at designated medical institutions and for purchasing approved medications and medical supplies [4] - It clarifies that while funds can be pooled, the eligibility for reimbursement and benefits must be accessed through individual medical insurance cards, meaning "money can be pooled, but cards cannot be shared" [4] - The pooling funds will follow the same clearing process as cross-provincial medical expenses, with a unified national clearing system in place [4]