In 2024, there were several new regulations regarding outpatient medical insurance for retirees in Beijing. Key highlights include adjusted reimbursement ratios, changes in out-of-pocket thresholds, an increase in the maximum reimbursement limit, and expanded scope of reimbursement for certain diseases and treatments, along with an expansion of the use of personal accounts for family members. Here are the details:
- Reimbursement Ratio Adjustment:
- For retirees under 70 years old, when seeking medical treatment in general hospitals, the reimbursement ratio for outpatient expenses within 20,000 yuan increased from 85% to 86%.
- For retirees 70 years old and above, the reimbursement ratio for outpatient expenses within 20,000 yuan in general hospitals increased from 90% to 91%.
- Out-of-Pocket Threshold Adjustment:
- The out-of-pocket threshold for retirees' outpatient medical expenses decreased from 1,300 yuan to 1,000 yuan. This means retirees need to pay less out of their own pockets before the insurance reimbursement kicks in.
- Increase in Maximum Reimbursement Limit:
- The maximum reimbursement limit for retirees' outpatient medical expenses increased from 20,000 yuan to 30,000 yuan. This provides more financial protection for retirees with relatively high outpatient medical costs.
- Expansion of Reimbursement Scope for Certain Diseases and Treatments:
- Some chronic diseases such as rheumatoid arthritis and ankylosing spondylitis were added to the scope of outpatient special disease reimbursement. This allows retirees suffering from these diseases to receive more substantial reimbursement for related treatment expenses.
- For some rehabilitation treatments, the number of treatment items covered by insurance increased, and the reimbursement ratio also improved. For example, more types of rehabilitation therapies for stroke patients are now covered.
- Expansion of Personal Account Use for Family Members:
- Starting from December 9, 2024, the personal accounts of Beijing's urban employee basic medical insurance participants (including retirees) can be used to pay for the relevant expenses of their close relatives that meet the regulations of the personal account use scope. Close relatives include spouses, parents, children, siblings, grandparents, grandchildren, etc., as long as these relatives are Beijing's basic medical insurance participants. This measure improves the utilization efficiency of personal accounts.
In general, the new outpatient medical insurance regulations for retirees in Beijing in 2024 are more beneficial to retirees, reducing their medical burden and providing more comprehensive medical security. Retirees should pay attention to relevant policies and procedures to ensure they can enjoy corresponding benefits.
