From 65438+ 10/month, the basic medical insurance for urban and rural residents in Shanghai will be unified, and the card can also be used for real-time settlement.

The minimum threshold is: 50 yuan, a first-class medical institution; 100 yuan, a secondary medical institution; 300 yuan, a third-class first-class medical institution (each time). The medical expenses incurred by insured residents in each hospitalization, which exceed the Qifubiaozhun, shall be paid by the urban and rural residents' medical insurance fund in different proportions according to the hospital level: 70%-90% for the elderly and severely disabled people aged 60 or above; 60%-80% of people under 60.

The proportion of medical insurance reimbursement for urban residents is:

Medical expenses below RMB 6,543,800 (students and children: RMB 6,543,800+RMB 8,000) incurred by the elderly over 70 years old, other urban residents, students and children within the scope of reimbursement. 500 yuan, the lowest threshold for tertiary hospitals, has a reimbursement rate of 50% (students and children: 55%); The qifubiaozhun for secondary hospitals is 300 yuan, and the reimbursement rate is 60%; The reimbursement rate of first-class hospitals is 65%.

The scope of medical insurance for urban and rural residents is as follows:

1, general outpatient card. In designated hospitals and pharmacies, the insured can use the password on the POS card to use the urban and rural residents' medical insurance card, but they cannot withdraw cash or transfer money. Urban and rural residents' medical insurance cards can be used to buy medicines at designated pharmacies at ordinary times, and can also be used to pay for some medicines at pharmacies.

2, hospitalization credit card, designated medical institutions must show their medical insurance card and my ID card (household registration book) when they enter the hospital, and be reimbursed on the spot according to the policy proportion when they leave the hospital.

To sum up, the impact of medical insurance policy for urban and rural residents in Shanghai in 2023 is a topic worthy of attention. The implementation of this policy will have a far-reaching impact on the medical security of urban and rural residents, which may improve the allocation of medical resources, improve the level of primary medical services, reduce the burden of medical care for residents and promote medical equity. At the same time, it may also bring some challenges, such as the collection and distribution of medical insurance funds and the adaptation and adjustment of medical institutions. Therefore, it is necessary to conduct in-depth research on the implementation of this policy in order to better understand its impact on the medical security of urban and rural residents and provide reference for the improvement and implementation of the policy.

Legal basis:

People's Republic of China (PRC) social insurance law

Article 23

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations.

Article 27

Individuals who participate in the basic medical insurance for employees will not pay the basic medical insurance premium after retirement and enjoy the basic medical insurance benefits in accordance with the provisions of the state if they reach the statutory retirement age and the accumulated payment has reached the fixed number of years stipulated by the state; Those who have not reached the fixed number of years prescribed by the state may pay the fees to the fixed number of years prescribed by the state.