Shandong first opened urban and rural medical insurance integration system, serious illness insurance cap 300 thousand
new network Ji'nan November (Sun Tingting Zhang Xuxu) the first open medical insurance system for urban and rural residents in Shandong, urban and rural residents in the same An equal medical insurance system under the medical insurance system. After the implementation of the unified residents' serious illness insurance system, the proportion of compensation is no less than 50%, and the ceiling line has increased to 300 thousand yuan.
at the news conference on the operation of the basic medical insurance system of the residents of the Shandong Provincial People's Government on the 26 day, the China new network reporter learned that from this year, the policy has been tilted to the patients with major diseases. The major diseases insurance has been compensated only by the original NCMS for the 20 types of major diseases. . The part of a person who has accumulated more than a certain amount of compensation shall be compensated by the residents' serious illness insurance.
"allocate funds according to the standard of 32 yuan per person, purchase serious illness insurance to commercial insurance institutions, and the province raises 2 billion 300 million yuan for serious illness insurance funds." Sun Tingyu, deputy director of the Shandong Provincial Department of human resources and social security, said that this year, Shandong province re tendered tenders to determine the residents' serious illness insurance and undertake commercial insurance institutions. "The profit and cost of the insurance for the insurance of the residents are not more than 2% of the total amount of the total fund for the residents' disease insurance in the year, and more than 2% of the funds are returned to the basic medical insurance fund. The loss is borne by the commercial insurance agency. "
except for serious illness insurance, the reimbursement scope of residents' drugs can be expanded, and the varieties of drugs used by rural residents will be expanded from 1100 to 2400. The vast majority of cities have implemented the general outpatient coordination system, while expanding the range of outpatients with chronic diseases, and the reimbursement ratio has increased from 56% before consolidation to 58%. In addition, the principle of overall treatment is not reduced everywhere, and the proportion of hospitalization reimbursement has been further improved.
"the basic medical insurance for residents is implemented at the municipal level, and in principle, the system is centralized and unified." Sun Tingyu, a city that has no conditions for the time being, can first establish the city level adjustment gold system, and the proportion of the county (city and district) on the solution of the adjustment of gold is not less than 20% of the income of the current fund. By 2017, all municipalities could achieve unified fund collection.
it is understood that after the integration of the medical insurance system of the residents, the city level of Shandong province has been integrated, and the urban and rural participants can choose the medical treatment independently in the whole area. The medical expenses can be put on the Internet in the whole province. The medical expenses can be settled immediately. And so on.