Medical insurance wallet version 2.0 is online. How to use this money?

The reporter learned from the media interpretation meeting of version 2.0 of the medical insurance wallet held by the National Medical Insurance Administration today (5th) that the medical insurance wallet has been upgraded to version 2.0. At present, intra-provincial mutual assistance of employee medical insurance personal accounts has been fully realized across the country; relying on the medical insurance wallet, the implementation of mutual assistance of personal accounts across provinces has been accelerated. What is a medical insurance wallet? How to use the medical insurance wallet? In response to the issues that everyone is concerned about, the relevant person in charge has provided answers.

What is a medical insurance wallet? What's the use?

Medical insurance wallet is a way for employees’ personal medical insurance accounts to be shared across provinces, and it is a bridge to achieve cross-provincial sharing. Relying on the national unified medical insurance information platform, a personal medical insurance wallet is set up, and the quota is set for mutual aid, so that the funds in the personal account of employees can be used to pay the personal expenses incurred by close relatives for medical treatment and drug purchase in designated medical institutions according to regulations, as well as for insurance payment. The medical insurance wallet breaks the past geographical restrictions of mutual aid within the province of employees' individual accounts, and strengthens the family mutual aid function. The money in the employee's personal medical insurance account can not only be used by mutual aid for family members within the province, but also for cross-provincial mutual aid, converting "sleeping" personal account funds into "family health funds", making family care immediately accessible, reducing the burden of medical expenses on the people, improving the efficiency of fund use, and promoting a fairer and more sustainable system.

How to use the medical insurance wallet?

Insured people can complete binding, limit setting, and business inquiries without leaving home through online channels such as the National Medical Insurance Service Platform App and Alipay Mini Program, or they can go to offline medical insurance handling windows to perform related operations.

For some elderly people and children who do not have mobile phones, mutual aid sponsors only need to enter the name and ID number of the elderly or children in their own medical insurance wallet to complete inter-provincial mutual aid. When the elderly or children are the recipients of mutual aid, when they are settling for medical treatment and medicine purchase, the mutual aid initiator switches to the medical insurance code of the elderly or children through the "family account" on their mobile phones, and shows the medical institution at the given point to scan the code and settle. When there is a personal burden in the medical insurance settlement of the elderly or children, the system will automatically deduct the corresponding amount from the mutual aid limit of the medical insurance wallet of the person being assisted.

Why do some designated medical institutions still not support the use of medical insurance wallets for medical treatment and drug purchase?

Currently, recipients can use the Mutual Aid Credits of version 2.0 of the Medical Insurance Wallet to seek medical treatment at designated medical institutions in insured areas and purchase medicines at designated retail pharmacies. By the end of this year, it will be possible to use the Mutual Aid Credits of the Medical Insurance Wallet Version 2.0 to purchase medicines across provinces. Because designated medical institutions need to develop software interfaces one after another, the settlement time of each institution's medical insurance wallet is slightly different. If the insured person needs to use the medical insurance wallet limit to make purchases at a designated medical institution, he or she can confirm in advance whether the other party can settle the payment.

What optimizations and upgrades does Medical Insurance Wallet 2.0 have compared to version 1.0?

At present, version 2.0 of the medical insurance wallet has achieved inter-provincial mutual assistance, which is mainly reflected in three aspects:

First, the scope of mutual aid continues to expand, from spouses, parents, and children in the past to close relatives such as brothers, sisters, grandparents, grandchildren, and grandchildren.

Second, the scope of use continues to expand. The medical insurance wallet version 2.0 has cracked the regional restrictions on the use of mutual aid funds by mutual aid recipients. In the past, it was limited to the area where the mutual aid recipients were located, and will soon be expanded to support cross-provincial use. It has also expanded from medical purchase and drug purchase to urban and rural residents’ medical insurance and long-term care insurance participation and payment. It will further revitalize the individual account funds accumulated by the mutual aid recipients and reduce the financial burden of the mutual aid recipients seeking medical treatment in other places.

Third, the operation is more convenient. The medical insurance wallet version 2.0 has strengthened the functions of identity verification, mutual aid relationship binding, mutual aid quota management and control, and risk warning functions.

Where did the medical insurance wallet 1.0 quota go? Will it be lost?

The unused mutual aid quota of version 1.0 of the medical insurance wallet is always kept intact. Open the National Medical Insurance Service Platform App - Medical Insurance Wallet, and the "Historical Limit" column displays the unused limit of the medical insurance wallet version 1.0. Moreover, this amount is still available. In the future, the interface will be optimized to display "Medical Insurance Wallet Version 1.0 Quota", "Medical Insurance Wallet Version 2.0 Quota" and "Medical Insurance Wallet Total Quota" respectively. When insured people settle for medical treatment and drug purchase, priority will be given to using the balance of the medical insurance wallet version 1.0.

Implementation status of national employee medical insurance personal account mutual aid

The Medical Insurance Center of the National Medical Insurance Administration also reported the implementation of the national employee medical insurance personal account mutual aid.

From the perspective of provincial mutual aid, in the first three quarters of this year, there were 380 million mutual aid trips across the country, with a total aid amount of 46.762 billion yuan, of which 371 million were used to pay medical expenses for close relatives, with an amount of 44.520 billion yuan, and 9.14 million were used for close relatives to participate in urban and rural residents' medical insurance and long-term care insurance personal payments, with an amount of 2.242 billion yuan.

From the perspective of cross-provincial mutual aid, up to now, since the medical insurance wallet version 2.0 was launched on September 29, there have been 1.8174 million cross-provincial mutual aids, and the mutual aid amount has been 1.457 billion yuan. The cumulative amount of medical and drug purchases was 47.0704 million yuan. A total of 590,400 residents’ medical insurance payments worth 225 million yuan have been paid.

As of now, there are 754,100 designated medical institutions across the country that support medical insurance wallet consumption, including 365,500 designated medical institutions (accounting for 80.92% of the total number of designated medical institutions). In addition to Anhui, Hubei, Hainan, Guizhou, and Shaanxi, 2 Seven provinces have achieved full coverage of designated medical institutions; 388,600 designated retail pharmacies have been covered (accounting for 89.28% of the total number of designated retail pharmacies). In addition to Anhui, Hubei, Guangdong, Hainan, and Shaanxi, 27 provinces have achieved full coverage of designated retail pharmacies.

In addition to Liaoning, Shandong, Tibet, Qinghai, and Ningxia, 322 coordinated areas in 27 provinces (autonomous regions and municipalities) have supported recipients to use the medical insurance wallet version 2.0 to pay insurance fees in their locations.

Judging from the progress of various regions, in terms of business circulation:

The top five personal account transfer transactions and amounts are all in Beijing, Shanghai, Guangdong, Zhejiang, and Jiangsu, with the transfer amount accounting for 74.62% of the country's total amount;

The top five personal account transfers are Hebei, Henan, Gansu, Anhui, and Hunan, and the top five by amount are Hebei, Henan, Jiangsu, Hunan, and Anhui. The transfer amount accounts for 47.67% of the total amount in the country.

In terms of consumer use, including:

In terms of medical settlement, Hebei, Jiangsu, Henan, Tianjin, and Zhejiang ranked among the top five in terms of number of medical visits in the country; Hebei, Jiangsu, Henan, Hunan, and Zhejiang ranked in the top five in terms of medical settlement amount, accounting for 58.31% of the total amount of medical settlement in the country.

In terms of drug purchase settlement, the top five drug purchasers are Fujian, Hebei, Jiangsu, Hunan, and Yunnan; the top five drug purchase amounts are Fujian, Hunan, Jiangsu, Hebei, and Yunnan, accounting for 84.97% of the total drug purchase settlement amount nationwide.

In terms of resident medical insurance payment, the top five provinces in terms of number of insured participants and payment amount are Hebei, Henan, Gansu, Shanxi, and Hunan. The payment amount accounts for 78.16% of the total payment amount in the country.

The National Medical Insurance Administration stated that by the end of 2026, it will fully realize the direct settlement of cross-provincial medical and drug purchases for patients using the medical insurance wallet version 2.0. At the same time, it will strengthen fund supervision, make full use of big data, artificial intelligence and other technical means, strengthen abnormal monitoring and risk warning, improve the cross-provincial fund settlement and clearing mechanism, and protect the people's "medical treatment money" and "life-saving money".

(CCTV reporters Yang Yang and Wen Yongyi)