Connecting host: Shi Jiuyun/Xinjiang Daily reporter Ren Chunxiang Connecting guest: Sun Yujie, director of the Treatment and Security Division of the Medical Security Bureau of the Autonomous Region A few days ago, relying on the national unified medical insurance information platform, the autonomous region has realized the mutual aid of families in Xinjiang in the medical insurance personal account, that is, the money in the medical insurance personal account can be used by family members who are also in Xinjiang but in different regions. So, how to use medical insurance family mutual aid? How to apply for mutual aid for long-distance families? Whose health insurance card does the family use to see a doctor after family mutual aid? Recently, the reporter interviewed Sun Yujie, director of the Treatment and Security Division of the Medical Security Bureau of the Autonomous Region, on issues of concern to everyone. Q: What is Medical Insurance Personal Account Family Mutual Aid? Answer: Family mutual aid in the medical insurance personal account refers to the "authorization" of the basic medical insurance participant to provide the balance of the medical insurance personal account to the insured spouse, parents, children and other close relatives for use, such as to pay for the self-payment part of the compliant medical expenses. To put it simply, the money in the health insurance card can be used with the family. Among them, the insured person of the basic medical insurance for employees is a mutual aid person, and the spouse, parents, children and other close relatives who have been insured are the mutual aid person, and the mutual aid person and the mutual aid person are in the same basic medical insurance overall planning area, usually the same prefecture-level city, and the mutual aid of family members can be realized; If the mutual aid and the recipient are not in the same overall planning area but both are insured in the autonomous region, they can now also realize mutual aid, that is, mutual aid for families in different places in Xinjiang. Q: How do I use it after family support? Answer: After the family mutual aid, the insured person's medical insurance personal account has expanded the scope of the beneficiary group, the original can only be used by the insured person, after the family mutual aid and the insured spouse, parents, children and other close relatives in the designated medical institutions when the personal payment of medical expenses, can be paid by the personal account. At the same time, the scope of application of the personal account has also been expanded, which can be used to pay for the personal medical expenses incurred by my close relatives when they see a doctor in a designated medical institution, the personal expenses incurred in the purchase of drugs, medical equipment, medical consumables and other expenses in the designated retail pharmacies, and can also pay for the personal payment of the spouse, parents, children and other close relatives who have participated in the insurance to participate in the basic medical insurance and long-term care insurance, so as to realize mutual assistance between family members. Q: How many family members can be bound to Family Aid? Answer: The mutual aid of the personal account can be authorized to be used by one or more close relatives, and the object of mutual aid is limited to the spouse, parents, children, siblings, grandparents, grandchildren, and grandchildren of the insured person, and they also participate in basic medical insurance, including employee medical insurance and resident medical insurance. At the same time, it should be noted that family members do not include the spouse's parents, and their related close relatives. Question: How to apply for mutual aid for families in different places in Xinjiang? Answer: The application process and scope of application of family mutual aid in different places in Xinjiang are the same as those of family mutual aid in the same co-ordination area. Insured persons can use the Xinjiang medical insurance service platform APP, WeChat applet or Alipay to handle online through the "Employee Medical Insurance Personal Account Family Mutual Aid" function module to realize the mutual binding of family members in personal accounts and fund authorization, or they can handle it in the offline medical insurance hall. Q: How to apply online? Answer: The specific steps of the declaration: 1. Search and download the Xinjiang medical insurance service platform APP "Xinjiang medical insurance"; 2. Enter the "Service Hall" - "Business Handling" - "Personal Account Family Mutual Aid"; 3. Create a family member group, read the "Personal Account Family Members' Mutual Aid Commitment" and check it; 4. Select a relationship, invite members, and confirm that your personal information is correct. Select the relationship between the invitee and the insured, fill in the relevant information of the invitee, such as the invited wife, select the "spouse" relationship, and then fill in the relevant information of the wife, if there are children under the age of 16, directly enter the family member group after the invitation; 5. Members agree to accept the invitation, and relatives over the age of 16 need to enter the "Personal Account Family Mutual Aid" function and click the "Agree" button to perform face recognition and agree to accept the invitation; 6. After binding the account, authorizing the amount, and the relative accepts the invitation, both the insured and the relative can view all the members under the family member group. Members of a family member group can bind accounts to each other and authorize the amount. Only members who have participated in the basic medical insurance for employees can bind accounts to other members for the authorized amount; 7. Set the deduction order, if two family members bind an account to a relative at the same time, the relative can set the deduction order in the "Deduction Order Management" of "Mutual Aid Account Management". Q: How many family members can receive from the same insured person? A: There is no limit to the number of people. Q: After the family is on mutual aid, whose medical insurance card is used when seeking medical treatment and purchasing medicines? Answer: The principle followed by medical insurance is "I participate in the insurance, I enjoy the treatment", the principle remains unchanged after the family mutual aid, the insured must use his or her medical insurance card to see a doctor, and enjoy his medical insurance treatment according to the regulations. It is worth noting that the act of using other people's medical insurance cards to register for medical treatment is a "fake medical treatment", which can be a suspension of online settlement of medical expenses, and at worst constitutes an illegal crime. Q: If the insured person accepts the mutual aid of several family members at the same time, who will use it first? Answer: The insured can set the priority of deduction and adjust it. When using a personal account to pay for medical expenses, the amount in the insured person's personal account will be deducted first, and the amount in the mutual aid account will be used if the amount in the personal account is insufficient. Q: After family mutual aid, can family members enjoy the reimbursement of up to 4,000 yuan a year for general outpatient services? A: No, you cannot. Family mutual aid is the money in the personal account of the mutual aid employee's medical insurance, not the medical insurance card itself, and the mutual aid person cannot enjoy the reimbursement treatment of the mutual aid person. That is, money can be shared, cards cannot be shared. The insured can give the money in their personal account to their family members, but what can be reimbursed for the medical treatment of the family members and how much they can be reimbursed is still determined according to the medical insurance system they participate in, and they enjoy the corresponding treatment according to the employee medical insurance or resident medical insurance respectively. Q: How to pay the individual payment of resident medical insurance for close relatives in the personal account of employee medical insurance? Answer: The personal account of the employee's medical insurance pays for the medical insurance of urban and rural residents for the members of the family mutual aid, and three conditions need to be met at the same time: the employee medical insurance participant and the urban and rural resident medical insurance participant must complete the binding of the family mutual aid member (the binding can be done through the "Xinjiang Medical Insurance Service Platform" App, WeChat applet, Alipay); Employee medical insurance is in normal insurance status; The balance of the employee's personal medical insurance account is sufficient to cover the application fee (i.e., the contribution of the family mutual aid member to participate in the medical insurance for urban and rural residents). Employee medical insurance participants can enter the "Xinjiang Medical Insurance Service Platform" applet, click on the "Service Hall" below after registering and logging in, select "Personal Account Family Mutual Aid", click on the "Individual Account Payment" of the recipient, select "2025" year in the "Payment Year" of the personal account payment page, select "Individual Mutual Aid" or "Family Mutual Aid" for "Mutual Aid Type" (individual mutual aid only deducts the amount of the payer's account, and Family Mutual Aid deducts the account amount of family members in the order of "Deduction Order Management"), and finally click " After the verification of the payment information is successful, the payment can be realized.
Source: Shi Jiuyun/Xinjiang Daily
Review: Liu Yu
Editor-in-charge: Guo Qinqin
Editor: Ma Xiaoyan