职工医保重大变化 个人账户可以给家人用了

2021.04.23

4月22日,国务院办公厅发布《关于建立健全职工基本医疗保险门诊共济保障机制的指导意见》(以下简称《意见》)。

2020年11月11日,在潍坊市寒亭区寒亭街道东院社区卫生室,医生王红霞为村民介绍医保服务下沉政策。(图片来源:新华社)

 

Under the guideline, immediate family members, including spouses, parents and children, will also be able to use the personal medical insurance accounts of insured employees for medical bills at designated institutions.
《意见》指出,职工个人医保账户可以用于支付参保人员配偶、父母、子女在定点医疗机构就医发生的由个人负担的医疗费用。

【词汇讲解】

Immediate family (members)指“直系亲属”,通常包括一个人的配偶、父母、子女;所有直系亲属加上七大姑、八大姨、叔叔舅舅等旁系亲属组成的大家庭就是extended family;只有夫妻二人加子女的小家庭则是nuclear family。

Their expenses incurred when purchasing medical devices, medicines and medical consumables at designated pharmaceutical stores can also be covered, the guideline said.
《意见》指出,在定点零售药店购买药品、医疗器械、医用耗材发生的由个人负担的费用也可由职工个人医保账户支付。

The unified accounts should include all employees insured under the basic medical insurance system and enable them to reimburse at least 50 percent of the outpatient fees, the guideline noted.
意见提出,普通门诊统筹覆盖职工医保全体参保人员,政策范围内支付比例从50%起步。

【单词讲解】

Reimburse指“补偿;报销”,比如:The airline reimbursed me for the amount they had overcharged me.(航空公司把多收的钱返还给我了);其名词形式是reimbursement,常用的搭配是reimbursement for...,比如: reimbursement for medical expenses(医疗费用报销),reimbursement for travel expenses(出行费用报销)等。

The guideline has called for efforts to take gradual steps toward reimbursing outpatient bills through unified accounts, with the medicines for chronic and common illnesses incorporated.
《意见》还提出逐步采取措施,实现在门诊发生的费用,用统筹基金支付,慢性病、常见病用药也纳入统筹支付。

 

【相关词汇】

医联体建设 to establish medical treatment partnerships to promote effective cooperation and coordination between different types of medical institutions

远程医疗 telemedicine

医保支付方式 models of health insurance payment

现代医院管理制度 modern hospital management system

医疗、医保、医药联动改革 the coordinated reform of medical services, health insurance, and the medicine industry

公立医院 public hospitals

民办医疗机构 private hospitals

因病致贫 fall into poverty because of illnesses

 

参考来源:新华网、中国日报

(中国日报网英语点津 Helen)

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