It is related to the province's urban and rural residents to pay medical insurance, and the interpretation comes

The Yangtze River Daily Da Wuhan Client September 7 (Correspondent Huang Shan reporter Hu Qiongzhi) On September 7, the Hubei Provincial Medical Insurance Bureau and the Provincial Taxation Bureau held a fare meeting for urban and rural residents' medical insurance insurance insurance. The basic medical insurance payment of urban and rural residents in Hubei officially begun. The annual personal payment standard is 350 yuan/person, and the annual urban and rural residents' medical insurance financial subsidies are not less than 610 yuan/person. March 31. At the press conference, the Hubei Provincial Medical Insurance Bureau and the Hubei Provincial Taxation Bureau were interpreted in detail about the issues that everyone cared about.

Who can apply for medical insurance for urban and rural residents?

1. Originally, residents who have been participating in the local insurance can no longer go through the procedures for participation in insurance participation and pay directly in accordance with local regulations.

2. New insured residents can participate in insurance payment through online and offline methods.

3. In principle, students in the school will uniformly organize insurance and payment.

4. Newborn, in principle, the registration of insurance participation shall be handled in accordance with relevant regulations within 90 days after birth, and premiums are exempted from birth. Newborns born before December 31, 2022 should pay the annual premium of 2023.

What reimbursement treatment can be enjoyed?

At present, the medical insurance of Hubei Province has fully realized the overall planning of the municipal level. Residents participating in the city enjoy the same medical insurance treatment, mainly including ordinary outpatient treatment, "two diseases" outpatient drug protection treatment, outpatient treatment and hospitalization (including maternity treatment, including maternity treatment To. 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 regions have broaden the designated medical institutions of "two diseases" to eligible medical institutions.

(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) of 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. The specific payment line is 6,000 yuan, 6,000 yuan lower than other residents. The reimbursement ratio is 5 percentage points higher than other residents. No sealed 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 insurance, patients with serious illness in the basic life of the family due to high medical expenses, after the rural revitalization and the civil affairs department as the target of medical assistance, their basic medical insurance and major disease The medical expenses after insurance reimbursement may be reimbursed again by medical assistance in accordance with regulations.

How to apply for medical insurance for urban and rural residents?

The first is the "door to the door". 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.

The second is "no meeting." 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. The third is the "Package Cooperative 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".

The fourth is "helping the office." While continuously improving the level of intelligent service, the medical insurance departments of various places adhere to the "two legs" walk, retain the traditional service methods familiar to groups such as elderly people, fully protect the special needs of groups such as elderly people, and provide insureds with the special needs of the elderly. Consultation, guidelines and other intimate services; reasonably equip service personnel, provide on -site services if necessary; simplify procedures, unblock channels for family members, relatives and friends, etc. to promote the elderly, implement agency services; Skilled, on -site staff provided the service office service.

[Edit: Yu Lina]

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