Basic medical insurance+major illness insurance+medical assistance, how strong the medical security of the difficult people

At the intersection News In 2018, since the reform of the institution, Jiangsu Medical Insurance Department will coordinate medical assistance and medical insurance, focusing on building a unified medical security system, and promoting the complementary connection of basic medical insurance, major illness insurance, and medical assistance systems. Essence What is the guarantee of the triple guarantee system for difficult people? At a press conference held by the Jiangsu Provincial Government on July 29, the first -level inspector of the Jiangsu Provincial Medical Insurance Bureau responded.

Basic medical insurance "insurance basic"

According to reports, in recent years, Jiangsu has comprehensively done a comprehensive basic medical insurance city -level coordination to enhance the ability of fund anti -risk. Establish a special disease guarantee system for outpatient clinics, and the major diseases that are suitable for long -term treatment in outpatient clinics are included in the scope of special disease guarantee in the outpatient clinic, and reference to hospitalization treatment guarantee. Establish and improve the support mechanism for the basic medical insurance clinic for employees, and enhance the help function of outpatient help. Implement the "two diseases" outpatient drug guarantee mechanisms for urban and rural participating residents' hypertension and diabetes. The province's medical insurance and residents' medical insurance policies in the province have stabilized the percentage of inpatient medical expenses funds within 85%and 70%, respectively, and the basic medical insurance subject guarantee functions are fully played.

Disease Insurance "Bao Di disease"

Employee medical insurance has established a large amount of medical expenses to "reimburse" the high medical expenses above the high amount of medical insurance. Residents' medical insurance establishes a major illness insurance system to determine 50%of the per capita disposable income of the residents in the previous year in order to make a payment standard for the per capita disposable income of residents. The payment ratio is set in sections. There is no maximum payment limit. The minimum reimbursement ratio has increased from 50%to more than 60%. The standard for the starting payment standard of the major illness insurance for eligible persons is reduced by 50%, and the reimbursement ratio is 5-10 percentage points higher than that of ordinary patients, further reducing the burden of medical expenses for the major diseases of the difficulties. The number of beneficiaries and fund expenditures in the province's major disease insurance increased from 315,000 in 2016 and 1.49 billion yuan, respectively to 564,000 and 5.33 billion yuan in 2021.

Medical assistance "bottom line"

Promote the unity of system standards, expand the scope of rescue steadily, implement funding participation, and do not set up a rescue line to the key rescue objects. At the highest amount of the annual maximum limit, it will be rescued. Rescue ratio. In conjunction with relevant departments, by adopting measures such as controlling the cost of controlling the drug and implementing multiple guarantees, the individual fees for the personal payment of rescue targets in the designated medical institutions in the county are controlled within 10%of the total hospitalization expenses within the scope of the policy. During the "Thirteenth Five -Year Plan" period, the province funded 13.52 million people to participate in insurance, directly rescued 38.28 million, and expenditure rescue funds reached 13.2 billion yuan.

Xinhua Daily · Jiaojiao Reporter Huang Hongfang

- END -