Shandong posts, these people can apply for assistance!

Recently, the General Office of the Shandong Provincial Government issued the "Implementation Opinions on Implementation of Medical Insurance and Rescue System" (hereinafter referred to as "Implementation Opinions"). Among them, if the medical assistance treatment conditions are met for patients with poverty -poverty and serious illness, after reimbursement of basic medical insurance and major illness insurance, the individual burden within the policy scope exceeds the per capita disposable income of residents per capita in the preparation area of ​​more than 25%. The ratio of less than 60%is given to rescue, and the annual rescue limit is not higher than that of the minimum allowance.

Residents of difficult residents participate in basic medical insurance according to law

Enjoy the rights and interests of the triple system

The "Implementation Opinions" proposes that the targets of medical assistance include: special difficulties, minimum guarantee objects, returning poverty -poverty population, members of the minimum -fidible family members, preventing the targets of poverty -stricken monitoring and assistance, and the scope of the above rescue objects, but due to high medical expenses due to high medical expenses Patients with severe illness in the family's basic life (hereinafter referred to as "patients with poverty due to illness").

Residents and employees in difficulties participate in basic medical insurance in accordance with the law, and enjoy the triple system (basic medical insurance, major illness insurance, medical assistance) in accordance with regulations. A classification funding is implemented for the rescue target participating in the personal payment of the basic medical insurance of the residents, of which full funding is given to the poor; members of the subsistence allowances, returning poverty -poverty, and members of the minimum -fideline family members and the prevention of the targets for preventing poverty -reward monitoring and assistance are provided.

In terms of strengthening the function of basic medical insurance and major illness insurance, enhancing the burden reduction role of major illness insurance, special difficulties, subsistence allowance objects, residents who return to the poor and poor people, and employees' serious illness insurance annual payment lines are compared to the medical insurance and employee medical insurance of residents and employees, respectively. Reduced by 50%, the proportion of segmented reimbursement increased by 5 percentage points, canceled the highest payment limit of the year of major illness insurance;

The annual rescue limits of the plenty of people are not less than 30,000 yuan

The "Implementation Opinions" proposes to implement the guarantee of medical assistance in classified layers. There is no annual payment line for medical assistance for special poverty, subsistence allowances, and poverty -poverty -poverty. After reimbursement of basic medical insurance and major illness insurance, the individual burden within the scope of the policy is not less than 70%. For 30,000 yuan. After the triple system guarantee, the individual burden within the policy scope will be re -rescued at a ratio of no less than 70%, and the annual rescue limit does not exceed 20,000 yuan. For members of the subsistence allowances and the targets of preventing and helping to return poverty, after reimbursement of basic medical insurance and major illness insurance, the personal burden of more than 3,000 yuan within the scope of the policy will be rescued at no less than 50%. Protection object. After the triple system guarantee, the part with an individual burden of more than 10,000 yuan within the scope of the policy will be re -rescued at a ratio of not less than 70%, and the annual rescue limit does not exceed 20,000 yuan.

Establish patients with poverty -stricken diseases in accordance with the application for rescue mechanism. For medical assistance treatment conditions for patients with poverty and serious illness due to illness, after reimbursement of basic medical insurance and major illness insurance, the individual burden within the policy scope exceeds the per capita disposable income of residents per capita in the preparation area of ​​more than 25%. The 60%ratio is given for assistance, and the annual rescue limit is not higher than that of the minimum allowance. Personal burdens can be traced back to 12 months before the application of the application. One identification can enjoy a medical annual rescue treatment and rescue limit, and the application shall not be repeated within a year.

Implement "first diagnosis and after -treatment" on the poverty -stricken person

The "Implementation Opinions" proposes to strengthen early warning of high medical expenses expenditure. Focusing on the reimbursement of basic medical insurance and major illness insurance, individuals have accumulated a total burden on a minimum -guaranteed edge family member who exceeded the per capita disposable income of residents in the province and the target of preventing poverty monitoring and assistance. Ordinary insured persons with 150%per capita disposable income are included in the monitoring mechanism. Incorporate the eligible residents and employees in a timely manner into the scope of rescue to ensure that it is assisted.

In terms of regulating the management services of the management, the "Implementation Opinions" proposes to improve the level of comprehensive service management. Implement "first -diagnosis and after -payment" to fully remove the hospitalization deposit. Each city can include the proportion of external expenses of the medical insurance catalog of rescue targets into the assessment management of the designated medical institution agreement to reduce the personal burden of the rescue target.

Source: Shandong Provincial Government Website, Xinhuanghe Client

Edit: Sun Bei

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