焦点1缴费年限 Focus 1 capture expends fixed number of year

由10年拟延长至15年 By 10 years to extend to 15 years

　　《条例》颇具争议的规定是，广州市医保缴费年限将由目前的10年延长到15年。

《regulations》Controversial provisions is，Guangzhou medical insurance capture expends fixed number of year of the current 10 years will be extended to 15 years。

　　2001年发布的《广州市城镇职工基本医疗保险试行办法》(以下简称《试行办法》)规定，医保缴费年限为10年。新的《条例》规定，医保缴费年限将延长5年，达到15年。同时，《条例》适用对象范围扩大至区域内的在校学生、本市户籍的灵活就业、非从业人员、学龄前儿童以及不能按月领取养老待遇的老年居民和农民。

Released in 2001《Guangzhou town worker is basic medical insurance try out method》(Hereinafter referred to as《Try out method》)provisions，Medical insurance capture expends fixed number of year for 10 years。new《regulations》provisions，Medical insurance capture expends fixed number of year will extend the five years，Hit 15 years。At the same time，《regulations》Applicable object to expand the range of areas of the students、The registered permanent residence of this flexible employment、The non-practitioners、Preschool children and not to be gotten by the month endowment treatment of older residents and farmers。

　　《条例》规定，新参保人员达到法定退休年龄时，在本市累计缴纳社会医疗保险费满15年的，不再缴纳医保费，享受退休人员医保待遇；未达到规定缴费年限的，可在本市继续参保缴费至规定的年限后，享受退休人员医保待遇。

《regulations》provisions，New ginseng protect personnel when reaching legal and emeritus age，In this city accumulative total pay society insurance premium of medical treatment is full 15 years，No longer pay medical insurance fee，Enjoy retiree health care treatment；Did not reach the provisions of capture expends fixed number of year，In this city can continue to ginseng protect capture expends fixed number of year to the provisions，Enjoy retiree health care treatment。

　　据悉，该条款将按照新人新规定、老人老办法的原则予以实施。也就是说，在条例实施前已参加城镇职工基本医疗保险的参保人员，仍按10年的累计缴费参保期计算退休待遇。条例实施后的参保人员，需累计缴满15年。与养老保险退休待遇领取缴费年限同步。

It is reported，This clause will be in accordance with the provisions of the new couple、The principle of old old man shall be implemented。That is，In prior to the implementation of the regulations have joined in a town worker is basic medical insurance ginseng protects personnel，Still press 10 years of accumulative total capture to expend ginseng protect period calculation retirement pay。After the implementation of the regulations of ginseng protect personnel，Need to accumulative total pay is full 15 years。And emeritus pay endowment insurance expends fixed number of year for synchronization。

焦点2保费使用 Focus 2 premium use

个人账户资金亲属可用 Individual account capital available relatives

　　《条例》对建立“一制多档”的社会医疗保险制度作了原则性规定，提出广州将建立资金来源多渠道、缴费和待遇标准多档次、满足各类人群基本医疗需求的多层次社会医疗保险制度。

《regulations》To establish“A file system more”Insurance of social medical treatment of system www.georgeson.com，Guangzhou will build put forward of financing source much channel、Pay cost and treatment standard many grade、Meet all kinds of people of basic medical needs multi-level social medical insurance system。

　　据悉，广州在下一步制定条例配套实施办法时，拟将社会医疗保险按不同的缴费标准及相应的待遇标准具体分为五个保险档次。

It is reported，Guangzhou in the next step for supporting the measures for the implementation of the regulations，Insurance of social medical treatment will be proposed to the pay cost standard according to different and the corresponding treatment standard specific divided into five insurance class。

　　《条例》规定，社会医疗保险统筹基金支付参保人员的医疗费用，应当符合社会医疗保险用药范围、诊疗项目范围、医疗服务设施范围和支付标准以及社会医疗保险的其他规定。社会医疗保险统筹基金支付急诊抢救、特殊疾病医疗费用的具体范围与办法，由市人民政府另行制定。

《regulations》provisions，Social medical treatment is sure to plan as a whole fund pays ginseng protect personnel medical costs，Social medical insurance shall be in conformity with the limits using drug、Diagnosis and treatment project scope、Facilities of medical treatment service scope and pay standards and other provisions of the social medical insurance。Social medical treatment is sure to plan as a whole fund pays emergency rescue、Special disease medical expenses specific scope and methods，Shall be separately formulated by the municipal people's government。

　　值得注意的是，划入参保人员个人医疗账户的资金可用于支付本人或其亲属的医药费用，但不得提取现金，不得用于支付非医药用品费用。

Note the，Ginseng protect personnel to delimit individual account capital can be used for the medical treatment pay for themselves or their families medical costs，But not extract cash，May not be used to pay the medical supplies cost。

焦点3参保范围 Focus 3 ginseng protect range

强制在校生参加医保 Forced students to participate in medical care

　　《条例》规定，用人单位及其在职职工和退休人员应当参加本市职工社会医疗保险；在校学生应当参加本市城乡居民社会医疗保险；其他人员可根据经济承受能力选择参加本市职工社会医疗保险或者城乡居民社会医疗保险。

《regulations》provisions，The employing unit and its on-the-job worker and retiree should attend this city worker of social medical insurance；Students should attend to the urban and rural residents social medical insurance；Other personnel can according to afford choose to participate in this city worker insurance of social medical treatment or urban and rural residents and social medical insurance。

　　吴明场指出，广州从2008年开展在校学生参加基本医疗保险工作以来，城镇居民医疗保险较好地保障了广大在校学生的医疗需求。但由于国家和省的有关文件规定对学生参加城镇居民医疗保险均体现自愿原则，导致部分在校学生的疾病风险意识不强、参保积极性不高，出现了多例未参保学生因出现重大疾病而医疗费用没有保障的情况。加上国家和省多个文件要求城镇居民医疗保险参保率要达到95%，大中专学生参保率达到100%，因此，《条例》在强制用人单位和职工参保的基础上，对在校学生参加社会医疗保险作了强制规定。

Wu Ming field points out that，Guangzhou launch in 2008 students attend insurance of primary medical treatment since the job，Medical insurance for urban residents better guarantee the students needs of medical treatment。But because the country and province the relevant documents of the regulations of the students to participate in medical insurance for urban residents are reflected voluntarily，In some of the students at school disease risk consciousness is not strong、Ginseng protect enthusiasm is not high，Appeared more cases did not join protect students for major diseases and medical expenses appear no guarantee。Plus countries and provinces more files required medical insurance for urban residents CanBaoLv should reach 95%，College students CanBaoLv reached 100%，so，《regulations》The mandatory unit of choose and employ persons worker ginseng protect basis，To guide the students to participate in social medical insurance for compulsive regulation。

焦点4欠费补缴 Focus 4 to owe a fee payment

三个月内可追溯待遇 Three months after the traceability treatment

　　按照《条例》，参加社会医疗保险并按时足额缴费的人员，按规定享受相应的社会医疗保险待遇。用人单位和个人欠缴社会医疗保险费的，停止享受社会医疗保险待遇。但在三个月内补缴欠缴费用、利息和滞纳金的，给予计算缴费年限，并可按规定给予追溯享受社会医疗保险待遇；超过三个月补缴的，给予计算缴费年限，不予追溯享受社会医疗保险待遇。

According to《regulations》，To participate in social medical insurance and on time full specified amount capture expends personnel，According to the regulation enjoys corresponding social treatment of medical treatment insurance。The employing unit and individual capture the social medical treatment insurance premium，Stop to enjoy treatment of medical treatment insurance society。But in the three months owing capture cost、Interest and fine for delaying payment，To calculate capture expends fixed number of year，And can give by the regulation, enjoy social trace back to the treatment of medical treatment insurance；More than three months of payment，To calculate capture expends fixed number of year，Will not be back to enjoy social treatment of medical treatment insurance。

　　同时，此前“广州医保基金亏空2.8亿元”的传闻引发各界关注，今后，广州将组建专门委员会“盯紧”医保基金的运营等情况。

At the same time，after“Guangzhou medical insurance fund deficit of 280 million yuan”By rumours of the attention from all circles，In the future，Guangzhou will form a special committee“Gaze at the”Medical insurance fund operation, etc。

　　《条例》提出，广州市政府将成立由政府相关部门、相关行业协会、用人单位、学校代表、参保人员、工会以及有关专家等组成的社会医疗保险监督委员会，定时听取社会保险经办机构关于医疗保险基金的征缴、使用、管理和投资运营情况的汇报，发现存在问题的，应当提出整改建议，或者向有关行政部门提出处理建议。

《regulations》Put forward，Guangzhou municipal government will establish the relevant government department、Related industry association、The employing units、School rep.、Ginseng protect personnel、Trade unions and relevant experts and other components of the insurance of social medical treatment of supervision committee，Time to listen to orgnaization of social insurance agency about medical insurance fund collects pay、use、Management and investment operation report，Found problems，Rectification shall put forward Suggestions，Or to the relevant administrative departments propose。