Hubei residents' medical insurance, starting from now!

The reporter of Hubei Daily from the Provincial Medical Insurance Bureau learned that the concentrated payment period of urban and rural residents' medical insurance in 2023 began from September 7 and continued until December 31. Personal payment standards are 350 yuan/person.

September to December is the concentrated insurance payment period for the province's urban and rural residents to pay the next year's basic medical insurance expenses. This year's concentrated insurance payment period has begun on the 7th. The Provincial Medical Insurance Bureau has arranged and deployed the provincial tax bureau on the payment of medical insurance participation in urban and rural residents in 2023. The work is progressing in an orderly manner.

In order to better and facilitate the people to understand important information such as residents 'medical insurance participation process and reimbursement benefits, the Provincial Medical Insurance Bureau and the Provincial Taxation Bureau were interviewed by the reporters of Hubei Daily on the relevant matters of urban and rural residents' medical insurance insurance for medical insurance. Provincial residents were released.

1. Payment standard

Resident medical insurance payment consists of two parts, that is, personal payment+fiscal subsidy. The annual personal payment is 350 yuan/person, and the annual urban and rural residents' medical insurance financial subsidies are not less than 610 yuan/person.

2. Concentrated payment period

The concentrated payment period of urban and rural residents' medical insurance in 2023 is from September 7 to December 31, 2022.

3. Reimbursement treatment

At present, the medical insurance of residents in our province has fully achieved municipal overall planning, and residents participating in the city enjoy the same medical insurance treatment. It mainly includes ordinary outpatient treatment, "two diseases" outpatient medication guarantee treatment, outpatient slow special disease treatment and hospitalization treatment (including maternity treatment). Personnel participating in the medical insurance of urban and rural residents participated in major illness insurance, and individuals do not need to pay for additional fees.

(1) Ordinary outpatient treatment

It is mainly at the outpatient medical and health institutions such as the township and township hospitals of the town and the village clinics. In principle, the proportion of medical expenses within the scope of ordinary outpatient policies is not less than 50%. In 2023, the overall payment limit of ordinary outpatient clinics in various places is not less than 350 yuan. The specifically specified in local policies.

(2) Hypertension and diabetes outpatient medication guarantee treatment

Relying on the secondary and below designated grass -roots medical institutions, the "two diseases" of "two diseases" who are not included in the clinic slow special disease protection scope of the main disease protection scope of the outpatient clinic are required, and the drugs that reduce blood pressure and lower blood sugar are included in the outpatient clinic. The scope of protection, the proportion of payment within the policy scope is more than 50%. At present, some areas in the province have broaden the designated medical institutions of "two diseases" to qualified medical institutions that meet the conditions.

(3) Slow special treatment of outpatient clinics

Slow -decentralized diseases include 14 categories, specifically for malignant tumor outpatient chemotherapy, chronic renal failure dialysis, organ transplantation outpatient anti -reject therapy, systemic lupus erythematosus, diabetes, renewable anemia, hypertension (pole extreme pressure (pole extreme pressure (pole High -risk), severe mental illness, chronic severe hepatitis antiviral treatment, cirrhosis, hemophilia, Parkinson disease, Parkinson syndrome, rheumatoid arthritis. Based on the income and expenditure of local medical insurance funds and local disease spectrum, various localities have appropriately expanded the scope of slow disease diseases. In principle, the proportion of the urban and rural residents' medical insurance funds within the scope of the outpatient slow disease policy is not less than 50%. Specific diseases and reimbursement policies shall prevail in various regulations.

(4) Residential treatment

The medical expenses in the medical insurance catalog occurred in the medical insurance catalog of medical insurance participants in urban and rural residents. The limit is about 120,000 yuan. The specific annual limit is subject to regulations.

(5) Disease insurance treatment

On the basis of basic medical insurance reimbursement, major illness insurance provides further reimbursement of high medical expenses incurred by the insured. High medical expenses incurred in the treatment of medical insurance patients in urban and rural residents or special chronic disease clinics, after the basic medical insurance of urban and rural residents is paid in accordance with regulations, the medical expenses within the cumulative scope of the individual's annual annual burden exceeding the major illness insurance payment standards are above the or higher. The segments of major illness insurance are reimbursed proportionally. The cumulative amount of more than 12,000 yuan (inclusive) pays 60%of the less than 30,000 yuan (inclusive); 65%of the 10,000 yuan (inclusive) below 100,000 yuan (inclusive); 75%of the 100,000 yuan parts, the highest annual payment limit of the year, in principle, in principle, in principle No less than 300,000 yuan. Separate personnel, subsistence allowance objects, returning poor and poor people to enjoy the treatment of major illness insurance, specifically: 6,000 yuan for the starting line of major illness insurance, 6,000 yuan lower than other residents, and 5 percentage points higher than other residents. The insurance has no top line.

At the same time, in August 2022, the Provincial Government General Office issued the "Implementation Opinions on Implementation of Medical Insurance and Rescue System" to further reduce the burden of medical expenses for the people of difficult people and patients with major illnesses. In accordance with the principle of "first insurance and then rescue", participating in basic medical insurance, patients with severe illness in the basic life of a family due to high medical expenses, after the rural revitalization or civil affairs department as a medical assistance object, they have undergone basic medical insurance, and they are basic medical insurance. Medical expenses after the reimbursement of major illness insurance can be reimbursed again by medical assistance in accordance with regulations.

The Provincial Medical Insurance Bureau reminds the majority of resident friends

The following points are precautions for participating in payment payment

Need to pay special attention

First, avoid repeated insurance.

The same insured person repeatedly participate in the same basic medical insurance system or repeatedly participate in different basic medical insurance systems. Essence If the insured has appeared repeated insurance, it will trigger the system prompt or report an error when paying again, and the insured person needs to choose to retain an effective insurance relationship. Pay the fees.

In addition, the insured persons in accordance with the "Regulations on the Supervision and Administration of the Medical Security Fund" shall enjoy medical security treatment in accordance with regulations, and shall not be repeated.

Second, key groups ensure that one person is not falling.

In response to those in difficulties, the medical insurance departments at all levels will be included in the scope of medical security in accordance with the principle of "full receipt and not one person", and actively coordinate the financial, civil affairs, health, disabled federations, rural revitalization and other departments to implement the classification in accordance with regulations Funding policy. Encourage the short -term seasons of sex workers or flexible employees to participate in the medical insurance of residents in the household registration or permanent place without participating in the medical insurance of the employee, adding a medical insurance to themselves.

Third, the payment can be "processed nearby."

At present, there are four ways to pay for residents' medical insurance insurance.

"Housekeeper". When individuals participating in the insurance for the first time, they can apply for insurance registration in the county (city, district), township (street), village (community) service window in the county (city, district), township (street), village (community) service window; Pay the personal insurance fee.

"No seeing the office." A variety of online service methods have been opened, and the masses can register and pay for insurance participation and payment through Hubei Government Service Network and Hubei Office APP.

"Package joint office". At present, the province is promoting the implementation of the "one thing for urban and rural residents' medical insurance for medical insurance." Through the unicom and co -organized by the medical insurance and taxation department system, the registration of newborns and ordinary residents, the suspension or termination of the residents' participation in insurance, non -critical information change, premium declaration and fee confirmation and payment, medical insurance electronic voucher activation, etc. Stand -up and one network handling, effectively solve the problem of the pain points of current urban and rural residents' participation in insurance registration and payment of "two ends".

"Help for office".在不断提升智能化服务水平的同时，各地医保部门保留老年人等群体熟悉的传统服务方式，充分保障老年人等群体的特殊需求，在服务窗口为参保人员提供咨询、指引等贴心服务；合理Equipped with service personnel, provide on -site services if necessary; simplify procedures, unblocked family members, relatives and friends, etc. for the elderly to handle channels to promote agency services; if the insured is not skilled for the insurance mobile phone or intelligent terminal equipment, the on -site staff provides a help office office Teaching service.

In addition, the medical insurance system for urban and rural residents has been implemented for many years, and the masses have basically adapted to the annual insurance insurance payment model for concentrated payment. However, a few people still missed the payment period, which caused the unable to enjoy medical security treatment. In order to avoid such situations, the medical insurance department will promote the medical insurance policy into millions of households through multiple channels such as public welfare text messages, special promotional videos, and public accounts. The medical insurance departments at all levels will recently announce the address and consultation telephone of the service window on the official website to consult with the large people when they participate in the insurance.

If you still have other questions in medical insurance

You can call the following call for consultation

Source: Huang Shan, a reporter of Hubei Daily All Media Longhua, Huang Shan, Hubei Provincial Medical Security Bureau

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