近日，国家医保局、财政部印发《关于做好职工基本医疗保险个人账户跨省共济工作的通知》，要求做好职工基本医疗保险个人账户跨省共济工作，进一 步扩大共济范围。你的医保个人账户能帮家人跨省买单吗？能用于哪些支出？ 什么是跨省共济？ 简单来说，跨省共济就是参保人个人账户的钱能跨省让家人使用，比如在外务工的人，可以跨省让老家的亲人使用自己的医保个人账户资金。 哪些人可以成为共济对象？ 通知明确，除了配偶、父母、子女等直系亲属外，还包括兄弟姐妹、祖父母、外祖父母、孙子女、外孙子女等近亲属，并且一人可与多人互建共济关系。 共济资金能用于哪些支出？ 根据通知，职工医保个人账户资金可以支付近亲属在定点医疗机构就医发生的个人负担医疗费用，在定点零售药店购买符合规定的药品、医疗器械、医用 耗材发生的个人负担费用，以及参加城乡居民基本医疗保险、长期护理保险的个人缴费。 你的医保个人账户能帮家人跨省买单吗？ 需要提示的是，每个医保钱包账户单日限3笔转账，每笔转账金额不超过2000元。 职工医保个人账户能共济报销比例吗？ 个账共济只是共享资金，不涉及医保报销的资格、待遇及政策。 例如职工医保参保人将个账资金共济给参加居民医保父母，父母的医 ...

Core Viewpoint - The National Healthcare Security Administration and the Ministry of Finance have issued a notice to enhance the cross-provincial mutual aid for employee basic medical insurance personal accounts, allowing insured individuals to use their personal account funds for family members in different provinces [1] Group 1: Cross-Provincial Mutual Aid - Cross-provincial mutual aid allows insured individuals to use their personal account funds for family members, such as those working away from home, enabling them to cover medical expenses for relatives in their hometown [1] Group 2: Eligible Recipients - The notice specifies that eligible recipients for mutual aid include not only direct relatives like spouses, parents, and children but also siblings, grandparents, grandchildren, and other close relatives, allowing one person to establish mutual aid relationships with multiple individuals [2] Group 3: Eligible Expenses - Funds from the employee medical insurance personal account can be used to pay for personal medical expenses incurred by close relatives at designated medical institutions, purchase approved medications and medical supplies at designated retail pharmacies, and cover personal contributions to urban and rural resident basic medical insurance and long-term care insurance [3] Group 4: Fund Transfer Process - The transfer of personal account funds to eligible recipients is facilitated through the Medical Insurance Wallet, which is linked to the individual's medical insurance code. Both the donor and recipient must activate their Medical Insurance Wallets to enable fund transfers [4] Group 5: Transfer Limitations - Each Medical Insurance Wallet account is limited to three transfers per day, with a maximum transfer amount of 2000 yuan per transaction. If the transfer exceeds these limits, additional documentation may be required [9] Group 6: Reimbursement Implications - Mutual aid from personal accounts does not affect the reimbursement qualifications, benefits, or policies of the recipient. For instance, if an employee uses their personal account funds to assist a parent enrolled in resident insurance, the parent's reimbursement terms remain unchanged and are based on their own insurance coverage [9]

Core Viewpoint - The National Healthcare Security Administration and the Ministry of Finance have issued a notice to enhance the cross-provincial mutual aid for employee basic medical insurance personal accounts, allowing insured individuals to use their personal account funds for family members in different provinces [1] Group 1: Cross-Provincial Mutual Aid - Cross-provincial mutual aid allows insured individuals to use their personal account funds for family members in different provinces, which is particularly beneficial for those working away from home [1] - The notice specifies that mutual aid can extend to not only direct relatives like spouses, parents, and children but also to siblings, grandparents, grandchildren, and other close relatives, allowing one person to establish mutual aid relationships with multiple individuals [2] Group 2: Eligible Expenditures - Funds from the employee medical insurance personal account can be used to cover personal medical expenses incurred by close relatives at designated medical institutions, as well as for purchasing approved medications, medical devices, and supplies at designated retail pharmacies [3] - Additionally, these funds can be utilized for personal contributions to urban and rural resident basic medical insurance and long-term care insurance [3] Group 3: Fund Transfer Process - The transfer of personal account funds to family members is facilitated through the Medical Insurance Wallet, which is linked to the individual's medical insurance code. Both the donor and recipient must activate their Medical Insurance Wallets to enable this feature [4] - The process involves logging into the National Medical Insurance Service Platform App, confirming the use of the wallet, and submitting the necessary information for the transfer [6][10] Group 4: Transfer Limitations and Conditions - Each Medical Insurance Wallet account is limited to three transfers per day, with a maximum transfer amount of 2000 yuan per transaction. Exceeding these limits requires additional documentation [8][10] - It is important to note that mutual aid only involves sharing funds and does not affect the eligibility, benefits, or policies related to medical insurance reimbursement for the recipient [10]

本文转自【央视新闻微信公众号】； 近日，国家医保局、财政部印发《关于做好职工基本医疗保险个人账户跨省共济工作的通知》，要求做 好职工基本医疗保险个人账户跨省共济工作，进一步扩大共济范围。你的医保个人账户能帮家人跨省买 单吗？能用于哪些支出？ 什么是跨省共济？ 简单来说，跨省共济就是参保人个人账户的钱能跨省让家人使用，比如在外务工的人，可以跨省让老家 的亲人使用自己的医保个人账户资金。 哪些人可以成为共济对象？ 通知明确，除了配偶、父母、子女等直系亲属外，还包括兄弟姐妹、祖父母、外祖父母、孙子女、外孙 子女等近亲属，并且一人可与多人互建共济关系。 共济资金能用于哪些支出？ 根据通知，职工医保个人账户资金可以支付近亲属在定点医疗机构就医发生的个人负担医疗费用，在定 点零售药店购买符合规定的药品、医疗器械、医用耗材发生的个人负担费用，以及参加城乡居民基本医 疗保险、长期护理保险的个人缴费。 使用医保钱包界面返回成功后，点击完成，界面显示可以查询医保钱包余额，点击医保钱包转账申 请"按钮"，即可使用该功能。 填写被转账人基本信息，点击提交即可。要实现转账，接受共济转账的一方也需要开通医保钱包。授权 人转账成功后，被转 ...

Group 1 - The article provides a guide on how to activate and use the online medical insurance (医保) for purchasing medications, emphasizing the importance of activating the electronic medical insurance certificate [2][3]. - It outlines the steps for online ordering and payment using medical insurance, highlighting the necessity to select products marked with "医保" or "医保支付" to ensure eligibility for insurance payment [4]. - The article stresses the implementation of a drug traceability code system to ensure the safety and compliance of purchased medications, with a requirement for all sold drugs to have traceability codes by January 1, 2026 [5]. Group 2 - The online medical insurance purchasing service is gradually being promoted across various regions, and users are advised to check local announcements for specific platform support [6]. - The payment for online medical purchases primarily utilizes the balance in personal medical insurance accounts, generally applicable for purchasing over-the-counter (OTC) medications listed in the medical insurance directory [6].

Core Viewpoint - The Fujian province has implemented a new "cross-province medical purchase restriction" feature to enhance the security of insured individuals' medical accounts, requiring an authorization setup for using social security cards in out-of-province pharmacies [1][2]. Group 1: Authorization Setup - Insured individuals can enable the social security card for out-of-province medication purchases without visiting a physical service hall, using online channels such as the "Minzhengtong" app or WeChat/Alipay [3]. - The setup process involves searching for "card purchase settings" in the app, accessing the relevant page, and enabling the "cross-province" configuration switch [3]. Group 2: Direct Settlement for Chronic Diseases - To achieve direct settlement for outpatient chronic special diseases across provinces, insured individuals must complete three steps: qualification recognition for chronic disease treatment at their insured location, filing for cross-province medical treatment, and selecting a designated medical institution that offers direct settlement services [3]. - Insured individuals can handle the cross-province medical treatment filing either at their local medical insurance agency or through online platforms like the "National Medical Insurance Service Platform" app [3].

Core Viewpoint - The article emphasizes the increasing attention on medical insurance rights and protections, particularly in the context of cross-regional medical treatment, highlighting the need for better understanding of existing policies [1] Group 1: Policy Overview - Current policies allow insured individuals, including those receiving medical assistance, to enjoy direct settlement services for cross-regional medical treatment after completing the necessary registration [3] - The medical expenses for inpatient care, general outpatient services, and outpatient chronic special diseases are subject to the payment scope and regulations of the treatment location, while adhering to the insurance fund's standards and policies of the insured location [3] Group 2: Registration Process - Registration for cross-regional medical treatment can be completed through both online and offline channels [4] - Online registration is facilitated through various platforms, including the "National Medical Insurance Bureau" WeChat account, the National Medical Service Platform App, and Alipay [4] - Local exclusive channels are available in different provinces, such as the "E-Hubei" App in Hubei and "Jiangxi Service App" in Jiangxi, allowing users to complete the registration process [4] Group 3: Offline Registration - Offline registration requires individuals to visit local medical insurance service centers with necessary documents, including identification and residency proof [5] - After registration, insured individuals can access medical services at designated healthcare institutions in their residence area without needing to enroll in local basic medical insurance [5]

Core Viewpoint - The article emphasizes the increasing attention on medical insurance rights and protections, particularly regarding the policies for cross-regional medical treatment, highlighting the need for better understanding of these policies among the public [1]. Group 1: Policy Overview - Current policies allow insured individuals residing long-term in different regions to enjoy direct settlement services for cross-regional medical treatment after completing the necessary registration [3]. - The medical expenses for inpatient care, outpatient services, and chronic disease treatments are subject to the payment scope and regulations of the treatment location, while adhering to the insurance policies of the insured's home region [3]. Group 2: Registration Process - Registration for cross-regional medical treatment can be completed through both online and offline channels [4]. - Online registration is facilitated through various platforms, including the "National Medical Insurance Bureau" WeChat account, the National Medical Service Platform App, and local apps specific to provinces [5]. - Offline registration requires individuals to visit local medical insurance offices or service centers with necessary documents, including identification and residency proof [6]. Group 3: Benefits and Conditions - After completing the registration, insured individuals can receive medical services or purchase medications at designated medical institutions in their residing area using their medical insurance cards or electronic codes, without needing to enroll in local basic medical insurance [7]. - Medical assistance recipients can continue to enjoy benefits from their home region's insurance policies, such as government subsidies and special treatments, without losing their eligibility for these benefits [7].

Core Concept - The "Medical Insurance Wallet" is a new feature that allows for the pooling of individual medical insurance accounts among close relatives, facilitating medical expense payments and insurance contributions through a national medical insurance service platform app [2][3]. Group 1: Functionality of the Medical Insurance Wallet - The Medical Insurance Wallet enables insured individuals to transfer funds from their personal medical accounts to the wallets of close relatives [3]. - It can be used for settling medical expenses at designated medical institutions and pharmacies, with over 170,000 medical institutions and 100,000 retail pharmacies nationwide currently supporting this feature [4]. - Residents can also use the funds in their Medical Insurance Wallet for insurance premium payments [7]. Group 2: Availability and Usage - The Medical Insurance Wallet is available in 30 provinces, municipalities, and regions, with the exception of Guangdong, which has not yet launched the service [8]. - As of now, over 1.5 million insured individuals have activated and used the Medical Insurance Wallet, successfully transferring funds in 305,000 transactions, amounting to over 200 million yuan [9]. - Users are advised to check the local availability of the Medical Insurance Wallet before attempting to use it, as some areas may still be in the process of activation [8]. Group 3: Additional Features - The Medical Insurance Wallet allows for a change of usage location if the wrong insurance area is selected, with this feature currently available in 15 provinces [14][15]. - A "proxy activation" feature is available for those who may not be able to use smartphones, allowing family members to activate the wallet on behalf of others [16].

Group 1 - The core concept of the medical insurance wallet is that it allows insured individuals to transfer funds from their personal medical accounts to the wallets of close relatives for medical expenses and medication purchases, facilitating inter-provincial cooperation in using personal account funds [1][2][3] - Previously, personal medical accounts only allowed for intra-provincial cooperation, but now, if the insured participates in employee medical insurance and has surplus funds, they can transfer funds to family members in different provinces as long as those family members are enrolled in basic medical insurance locally [1][2][3] - The process to open a medical insurance wallet involves logging into the National Medical Insurance Service Platform App and confirming the use of the wallet, which is available in all regions [4][5][6] Group 2 - The wallet transfer application requires the sender to fill in the recipient's basic information and submit the request, with a limit of three transfers per day, each not exceeding 2000 yuan, and transfers cannot be made between 22:00 and 06:00 [29][15][18] - If the recipient's wallet is not opened, the transfer cannot be completed, and any unclaimed funds will be returned to the sender's account by 06:00 the next day [29][31] - The medical insurance reimbursement system operates under a directory management approach, where only expenses listed in the directory are eligible for reimbursement, and the directory is subject to annual adjustments by national and provincial authorities [32][33][34]