Q&A on Chinese medical insurance reform

Pharmacists check prescription information at a fever clinic in Shanghai’s Minhang district on Jan. 8. [Photo/Xinhua]

Q1:How does China’s health insurance system for employees work?

A: The health insurance system for employees has existed for more than two decades, consisting of statutory private accounts and joint public accounts. About 354 million people are enrolled in the program nationwide.

The public account consists of employer contributions and is used to pay for hospitalization, outpatient visits for serious illnesses and some chronic diseases. A personal account, established with personal and employer contributions, includes regular outpatient visits.

Q2: What was the recent health insurance reform about?

A: The Council of State issued guidelines in April 2021 calling for phased steps to be taken to establish a mutual assistance mechanism to cover outpatient bills through public accounts, so that regular outpatient visits can also be reimbursed through unified accounts.

In order to expand the capacity of unified accounts, a number of provinces have started transferring some of the money previously remitted to employees’ personal accounts to public accounts managed by the authorities and limiting the amount paid to retirees’ personal accounts to the average pension disbursed over a certain period of time. region.

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