Many people purchase resident medical insurance but may not fully realize its benefits.
However, this insurance offers numerous reimbursement techniques that can save hundreds or even tens of thousands annually, applicable nationwide. Below are the details.
One minor inconvenience is that many parents do not have a residence permit for large cities, so they need to submit a commitment letter for non-local medical treatment during the documentation upload process.
After successful registration, many cities also require selecting a designated outpatient facility. For example, in Guangdong, you can open the “Yue Yibao” mini-program and select “Outpatient Facility Registration” to designate a preferred hospital or community health center for outpatient services. Note that if you visit a non-designated facility, outpatient expenses will not be reimbursable. Additionally, for those with commercial insurance such as accident or outpatient coverage, if the medical insurance reimbursement is not utilized, the claim ratio may drop from 100% to 80% or even 60%, regardless of whether the treatment is local or non-local. Therefore, maximizing reimbursement through for outpatient expenses not only saves money but also ensures a higher claim ratio for commercial insurance. 2. Family Pooling for: Shared Use of Personal Medical Accounts Many individuals rarely visit hospitals, leaving their employee medical insurance balances unused. However, parents with still need to pay out-of-pocket for the portion not covered by reimbursement. By activating the “Family Pooling” feature, family members can use the personal medical account to pay for hospital visits, community health center medications, vaccinations, or even premiums. While the account balance is essentially funded by monthly contributions, it feels less burdensome than spending cash. Conversely, the personal account balances of parents or grandparents can also be used by younger generations, as long as they are direct relatives. The binding process is straightforward. In Guangdong, for instance, open the “Yue Yibao” mini-program, navigate to “I Want to Handle Affairs – View More – Personal Account Family Pooling Binding/Unbinding,” and follow the prompts. A common question is whether parents’ rural can be linked to one’s personal account. Family Pooling is not restricted to local cities; it can be activated alongside non-local medical treatment registration, enabling shared account usage across regions. Even if parents are enrolled in rural, they can still access reimbursement at designated urban hospitals and utilize the family’s medical account balance. Non-local outpatient reimbursement and Family Pooling can take effect simultaneously. However, a limitation is that most regions currently do not support cross-province Family Pooling. For families in different provinces, an alternative is to use the “National Medical Insurance Service” APP’s “Medical Insurance Wallet” feature to transfer personal account balances to family members’ wallets, indirectly achieving account sharing.Lastly, it’s important to clarify that some people confuse family pooling with dependent accounts. These are not the same.
Family pooling allows sharing the balance of a personal medical insurance account, reducing out-of-pocket expenses for medical visits. In contrast, a dependent account is not related to money. Its core purpose is to facilitate medical care by binding family members’ health insurance codes to your mobile device. Additionally, dependent accounts enable you to check the income and expenses of family members’ health insurance cards at any time without requiring their authorization. 3. Higher Reimbursement Rates for Chronic Conditions Under Resident Health Insurance Resident health insurance not only covers outpatient expenses and allows sharing of family medical account balances but also offers a significant cost-saving benefit. When using resident health insurance for outpatient services, applying for recognition of a chronic or severe illness can result in much higher reimbursement rates and limits compared to general outpatient coverage. This policy specifically targets individuals with severe illnesses (e.g., cancer, uremia) or chronic conditions (e.g., hypertension, diabetes, coronary heart disease, chronic hepatitis B) requiring long-term medication, potentially saving thousands or even tens of thousands annually. For example, in Chongqing, resident health insurance provides no reimbursement for outpatient visits at tertiary hospitals under normal circumstances. However, with chronic/severe illness recognition, reimbursement rates range from 40% to 55%, with generous annual limits. The recognition process is straightforward: apply directly at your regular hospital. Once approved, you’ll enjoy better reimbursement for related treatments. If you’ve completed cross-region registration and selected hospitals, you can also access these benefits outside your home region. 4. Final Notes Resident health insurance, costing just a few hundred yuan annually, offers substantial policy benefits for outpatient care. However, its weakness lies in hospitalization reimbursement. Many non-covered expenses receive no reimbursement, and even covered expenses have relatively low reimbursement rates. To alleviate the financial burden of major illnesses, supplementing with commercial medical insurance (e.g., million-yuan medical insurance) is advisable. Such plans offer high coverage limits for hospitalization costs and are affordable for both young adults and older individuals.
