Interpretation 丨 Connect basic medical insurance to ensure a comprehensive upgrade!2023 "Tianyi Ying Ningbao" was officially released!

100 yuan, what can I change?

One dinner, two movie tickets, a few books ...

In Ningbo, 100 yuan will include more definitions.

It can be an "strong heart agent" outdoors;

It can become a "reassinual pill" when it is sick.

It makes the "12 million stitches" sky -high anti -tumor treatment no longer dates;

When facing the test, it has a confidence through the haze and firmly together.

In Ningbo, 100 yuan, you can weave a "armor" of 30,000,000 yuan!

Pratt & Pitis hard to the people, and it is guaranteed. The launch ceremony of the "Tianyi Ying Ningbao" in 2023 was held today (September 20). The Ningbo Medical Insurance Bureau, Ningbo Finance Bureau, Ningbo Local Financial Supervision Bureau, Ningbo Banking Insurance Regulatory Bureau and 10 underwriters have witnessed the new release of "Tianyong Ningbao".

It is reported that "Tianyi Ning Ning Insurance" is a Huimin -type commercial supplementary medical insurance under the government. In 2021, Ningbo Local Financial Supervision Bureau, Ningbo Medical Insurance Bureau, and Ningbo Banking Insurance Regulatory Bureau selected 10 insurance companies (PICC Property & Casualty Insurance, Tai Insurance Property & Casualty Insurance, Tai Insurance Life Insurance, China Life Insurance, Ping An Pension, National Life Property & Casualty Insurance, Taikang Pension, China Union, Sunshine Property & Casualty Insurance) co -insured. Since the official insurance on September 1, 2021, it has effectively reduced the burden of high medical expenses of insureds and prevented ordinary people from returning to poverty due to illness. It is an important part of Ningbo's construction of a multi -level medical security system.

In 2023, the "Tianyi Ying Ning Insurance" further connects basic medical insurance, surrender premiums, raise protection, and simple procedures, and will benefit more insureds. The four major guarantee responsibilities can enjoy the medical expenses of up to 3 million yuan in the year: 1 million yuan in hospital for medical expenses for self -funded medical expenses for the outpatient medical clinic, 1 million yuan of malignant tumor prescriptions with self -funded drug cost guarantee, 700,000 yuan specific rare disease Pharmaceutical cost guarantee and 300,000 yuan of proton and heavy ion medical expenses. The insurance period is from September 20, 2022-December 25, 2022, and the guarantee period is January 1, 2023-December 31, 2023.

One -cut premium

The average of less than 0.3 yuan per day

The most intuitive change in 2023 "Tianyi Ying Ningbao" is the decline in premiums. From the original 139 yuan/person to an adult (born January 1, 2005 (excluding) before), 100 yuan/person, minor (born on January 1, 2005) 60 yuan/person Essence That is, adults spend about 0.27 yuan a day, and minors spend about 0.16 yuan a day to get the entire year's medical expenses for the entire year.

Two down payment line

The reimbursement threshold drops directly 14,000 yuan

In terms of the starting payment line that citizens are more concerned, the "Tianyi Ying Ningbao" in 2023 further implemented the original intention of "inclusive", and the threshold for claims dropped significantly ——

Inpatient and special disease outpatient medical expenses guarantee, malignant tumor prescriptions with self-funded drug cost guarantee, and specific rare disease drug costs have been reduced to 6,000 yuan, compared with 2021-2022 "Tianyi Yingning Insurance "The reimbursement threshold of 20,000 yuan directly reduced by 15,000 yuan. In terms of specific operations, in the cost of reimbursement conditions, less than 6,000 yuan will not be reimbursed; some non -old patients with 6,000 to 20,000 yuan will be reimbursed at 20%, and patients with past symptoms will be reimbursed at 10%; part of the part of more than 20,000 yuan is not permanent disease. Patients are reimbursed at 80%, and patients with past symptoms are reimbursed at 40%; proton and heavy ion medical expenses are guaranteed without rising lines. If you need to get a detailed reimbursement method, please pay attention to the WeChat public account inquiries of "Tianyi Ying Ningbao".

Three refer to reimbursement

Reimbursement ratio of malignant tumor special drugs

It is worth mentioning that in 2023, the "Tianyi Ying Ningbao" canceled the A and B directory settings of the Phasequites of Malignant Tumor Prescription. The insured person designated a prescription in Ningbo City and purchased a designated pharmacy in Ningbo for the treatment of malignant tumors. Drugs within the scope of major disease insurance payment are reimbursed according to a unified proportion.

In simple terms, there are only 35 types of drugs in the previous Class A. Those who meet the reimbursement conditions can be reimbursed at 80%of the patients, and patients with past symptoms are reimbursed at 40%. Class B drugs are reimbursed at 40%, and patients with past symptoms will be reimbursed at 20%. Since 2023, as long as it is currently being legally listed in China, the instructions are drugs for malignant tumors, and the use of reasonable and needed for the indication of the drug instructions is met, which is in line with the requirements of "Tianyong Ningbao" responsibility. , Can apply for reimbursement, and reimburse the reimbursement (equivalent to increasing the original B -drug reimbursement ratio, consistent with Class A medicine). This upgrade will effectively reduce the burden of self -funded drug expenses outside the preparation of malignant tumors.

Four -lifting time effect

"One -stop" settlement is more convenient

According to the "Fourteenth Five -Year Plan" plan, Zhejiang Province proposed the relevant requirements of "vigorously developing smart medical care and accelerating the realization of comprehensive and digital transformation of health and health".

As an important part of the national medical security information platform, Zhejiang's "Smart Medical Insurance" platform has a unified standard and unified encoding to comprehensively form a "one network" in the province's medical insurance. , Cross -level, cross -sector "One Netcom Office". On February 28, 2022, Ningbo launched the Zhejiang "Smart Medical Insurance" platform to press the acceleration key for the digital reform of Ningbo's medical insurance. In 2023, the settlement settlement of "Tianyi Ning Ning Insurance" is more convenient. Medical expenses for hospitalization and special illness clinics in Zhejiang Province can be settled in real time in medical institutions through swiping or scanning code in medical institutions, that is, simultaneously settlement with basic medical insurance. This will effectively alleviate the burden on the large medical expenses of patients, avoid the trouble of running the legs, improve the quality of service, and effectively use the "Tianyong Ningbao" to benefit the people, benefit the people, and the people.

Conservation is convenient

Payment of medical insurance accounts

Compared with last year, this year's insurance channels are more diverse. Citizens can use "Tianyi Ying Ningbao" WeChat public account, Zheli appointment APP, Alipay and other Internet platforms, the official public account, APP, sales personnel, service outlets, other people and platforms recognized by the underwriting agency Pay the fees.

At the same time, to open up the balance of employees' medical insurance accounts for the years, Ningbo medical insurance insured personnel can pay premiums in full deduction of the balance of funds for the employee medical insurance personal account.

"'Tianyi Ningbao' is a useful attempt to explore the development of Huimin -type commercial supplementary medical insurance. It is also a good practical practice related to the well -being of the people's livelihood. It is of great significance to do this work. It is the specific action of building a common prosperity and pioneering city, and it is an important measure to improve the multi -level medical security system, further weaving the medical security safety network, and enhance the sense of security, gain, and happiness of the masses. "Ningbo Municipal Medical Insurance Bureau related The person in charge said.

Reporter Shi Yan

- END -