@, Heavy!Foshan will realize cross -regional outpatient reimbursement

Improvement: citizen medical insurance treatment! Improvement: Foshan's maternity medical treatment standards! Implement: "Outpatient Fair" guarantee for employees and residents!

On the morning of June 17, the party secretary and director of the Foshan Medical Security Bureau Lin Jianwei launched the "Ask Foshan" program to introduce the new medical insurance policies and benefit measures.

Recently, the "14th Five -Year Plan" of the "Foshan Medical Security Development", which was reviewed and approved by the executive meeting of the Municipal Government, was officially issued and issued. This year, the Foshan Medical Insurance Bureau will focus on the following:

(1) Implementation rules for the implementation of ordinary outpatient protection protection of employees, residents, and new maternity insurance management measures;

(2) Amend the administrative measures for major illness insurance;

(3) Revised the guarantee measures for the hospitalization of employees and residents;

(4) Establish new medical assistance management measures;

(5) Deepen measures such as charitable donations and medical mutual assistance.

Employee and resident

Use the "personal account" medical insurance fund to improve citizens' medical insurance benefits

"2022 is the year of reform and reform of the medical security department." Lin Jianwei, secretary of the party group and director of the Foshan Medical Insurance Bureau, introduced that this year, the outpatient "support" reform of Foshan employees and residents will be promoted. In general, the reform ideas of "outpatient design, the city's selection, first aid office, and referral guarantee", as well as the principles of "consistent management methods and implementation of classification guarantee" of employees, urban and rural residents' outpatient guarantee systems, and the outpatient guarantee system of urban and rural residents. , Settlement Management and Personal Treatment, etc., make 24 optimization and adjustments to the current policies, actively respond to the demand and social concerns of citizens, and further enhance the protection of the rights and interests of participants.

"'Falling Furnish" can be understood as the insured to help each other, essentially refers to medical insurance. "Lin Jianwei introduced that the employee medical insurance fund is divided into two parts: the overall fund and medical insurance personal account. Therefore, the "support" guarantee reform that is about to be implemented can also be divided into "great affairs" and "small common a goodbye to "--

【Grand Promotion】

Refers to the medical insurance overall fund will establish an outpatient aid guarantee mechanism. By canceling the reform of the medical insurance personal account of the employee's medical insurance by canceling the current overall fund subsidy of the employee's medical insurance, it will increase the ability of the overall fund to improve the employee medical insurance clinic. At the same time, by adjusting the structure of the overall fund and personal account, the personal account funds deposited deposited without new units and individuals are not added.

For example, the scope of the reimbursement of ordinary outpatient clinics in the past was implemented by the medical insurance directory formulated by Foshan. Only three major conventional, black and white B ultrasound and other basic projects could be reimbursed, and medical consumables could not be reimbursed. After the implementation of the "Outpatient Affairs Guarantee", the provincial unified basic medical insurance drugs, diagnosis and treatment items, and medical consumables can be used in accordance with regulations. The scope and payment ratio will also increase.

【Xiao Junji】

Refers to personal accounts to achieve family favors. The scope of the use of medical insurance accounts will be expanded. It can be shared with children, parents, and spouses. In addition to paying for the self -funding of the medical treatment, you can also buy medicines, medical equipment, medical consumables, and purchase "Ping An Buddha Medical Insurance".

"Cross -regional outpatient clinic" new breakthrough

The city can choose at least 2 fixed -point medical institutions for medical institutions

"Everyone pays attention to the cross -district clinic choice, there is good news!" Lin Jianwei revealed during the live broadcast that Foshan's cross -regional outpatient clinic will be implemented in the second half of the year.

One of the highlights is that the insured can choose at least two medical institutions to enjoy the general outpatient treatment of medical insurance in the cross -zone.

In accordance with the reform ideas of "outpatient design, city selection, first aid special office, referral guarantee", and on the basis of implementing the national medical reform and the provincial government on ordinary outpatient clinics, at least one primary medical and health institution should be selected as a designated point. Foshan medical insurance The bureau fully responds to citizens' concerns, so that the insured can select medical institutions throughout the city to enjoy the treatment of ordinary outpatient clinics.

"Some participants' participation is in Chancheng, working, living in Gaoming and Sanshui; The district -level restrictions will be liberalized. For example, the insured of Shunde can choose to see the clinic for medical insurance at the New Hospital of Foshan Maternal and Child Health Hospital. "Lin Jianwei introduced.

At the same time, Foshan will further let go of ordinary outpatient qualifications. As long as qualified medical and health institutions can apply to become designated medical institutions for ordinary outpatient clinics. For example, the first hospital and municipal hospitals that citizens are concerned about can apply for designated medical institutions for ordinary outpatient clinics.

In addition, Foshan will also optimize and improve the selection policy of medical treatment in different places. Those who have resettled retirement, long -term residence in different places, and resident in different places, the insured can choose a designated medical and health institution with the specified number of homes in the filing place and the place of insured to solve the long -term extensive insured to seek medical treatment in the two places in the two places. The problem of enjoying treatment.

Birth two children, three children new favorable

Flexible employment participants can enjoy fertility medical expenses

The "Administrative Measures for Performance Insurance in Foshan City" led by the Foshan Medical Insurance Bureau will be implemented soon. The New Deal has adjusted and revised the current policies from the scope of guarantee personnel, fertility medical expenses, and maternity allowance benefits.

Increase the protection of flexible employment staff

Further link to the participation mechanism of flexible employment personnel, cancel the restrictions on participating in the insurance of flexible employment, and the flexible employees who participate in the basic medical insurance for employees, and you can enjoy maternity medical expenses without paying maternity insurance premiums.

Improve fertility treatment and enjoy the effective day

Enjoy the treatment conditions from the previous accumulated participation in maternity insurance to be adjusted to pay for the payment of the next month, and you can enjoy the treatment of maternity medical expenses.Expand the scope of fertility medical treatment

It is clear that the ectopic pregnancy termination of pregnancy, and the cost of diagnosis and treatment during family planning surgery and the cost of complications will be incorporated into the scope of the nuclear report of maternity insurance, and the fertility costs are 100%reimbursement.

According to the regulations

If the actual number of female employees' daily departure holiday days are lower than the number of days of holidays, the number of births in the holidays will be issued in accordance with the prescribed holidays to further protect the rights and interests of female employees.

Extend the time limit of sporadic reimbursement

Extend the time limit for fertility medical expenses sporadic reimbursement and maternity allowance.It can be applied within 3 years from the validity period of the first year.

Source: Minsheng Command Train, Foshan Medical Security Bureau

Edit: Foshan News Network Zheng Xiaoqi

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