The General Office of the State Council recently issued the "Guiding Opinions on Improving the Long term Mechanism for Basic Medical Insurance Participation" (hereinafter referred to as the "Guiding Opinions").
  The Guiding Opinions require clarifying the responsibilities of all parties and implementing legal insurance coverage; Improve policy measures to encourage continuous participation in insurance; Improve service quality and strengthen insurance coverage. The Guiding Opinions propose the following key measures.
One is to improve policy measures. Further liberalize and relax the registered residence restrictions on participating in basic medical insurance in places of permanent residence and employment. Promote linking the payment of residents' medical insurance with the level of economic and social development and the per capita disposable income of residents. Support the use of employee medical insurance personal accounts to pay for the personal contributions of insured individuals' close relatives participating in resident medical insurance, as well as the personal out of pocket medical expenses incurred by insured close relatives seeking medical treatment and purchasing drugs at designated medical institutions. Establish an incentive mechanism for major illness insurance benefits for residents who continue to participate in medical insurance and those who have zero reimbursement. The incentive for continuous participation and zero reimbursement should, in principle, be no less than 1000 yuan per increase in limit. Starting from 2025, except for special groups such as newborns, a fixed waiting period and a variable waiting period for benefits will be set up for individuals who have not been insured during the centralized period of resident medical insurance or have not been continuously insured.
The second is to optimize management services. Establish a national insurance database and implement "one person, one file" management. Carry out a centralized publicity campaign for universal participation in basic medical insurance every September. Promote the integrated processing of birth medical certificates, household registration, and medical insurance participation, simplify procedures, optimize processes, and encourage guardians to enroll newborns in insurance in the year of birth. Actively create conditions to include village clinics that voluntarily apply and meet the conditions in the scope of medical insurance settlement, and promote real-time settlement.
The third is to strengthen departmental collaboration. Clarify the main responsibilities of various relevant departments in the work of insurance participation, do a good job in population information data comparison, social insurance business coordination and linkage, newborn "birth one thing" services, mobilize and guide social forces to participate in medical assistance in accordance with the law, promote the coordinated development of basic medical insurance and commercial insurance, and promote information sharing.
The Guiding Opinions require all regions and relevant departments to strengthen organizational leadership, enhance comprehensive evaluation, ensure financial support, and ensure the smooth implementation of various measures.