The new health insurance policy will be implemented next month, including cupping and massage.
March 17th, the A9 edition of this newspaper reported two news reports on the adjustment of medical insurance policy. The new medical insurance policy, which began in April 1st, is good news for the residents of the medical insurance and the medical insurance participants. What convenience will this adjustment bring to the insured? This newspaper will do further reading for you.
What reimbursement links should be expanded?
the future emergency view fee can be reported to the medical insurance policy of the residents, which began to be adjusted in April 1st:
the medical expenses of the emergency observation after the emergency observation is directly transferred to the hospital after the emergency observation in the same fixed-point medical institution. Unified settlement of hospitalization expenses.
what is an emergency view? For example, the patient is sent to an emergency hospital for myocardial infarction. After the rescue, the patient needs to stay in the hospital and then turn to the hospital ward. The process before the hospitalization is the emergency view. The reporter learned that the medical insurance of the residents had not been clear about how to settle the expenses of the stay in hospital. In this policy adjustment, it was the first time to make clear. Different from the residents' medical insurance, there is a long history in the unified settlement of hospitalization expenses. That is to say, after April 1st, whether the "workers" or "residents" can be reimbursed by the insured people.
for residents insured by medical insurance, the benefits of this policy adjustment are obvious. For example, a patient with cerebral infarction was sent to the hospital for emergency treatment. In order to help the patient, the doctor could use some expensive "life protection items", which was also done in the emergency department, and the cost of the emergency part would be very high. When the patient is out of life, the patient is transferred to the ward, and the hospitalization stage is different from the emergency. It may only need a needle to observe, and the cost is far less than the emergency stage.
before the medical insurance of the residents did not explain the emergency view settlement, there would be a large number of emergency expenses that could not be reimbursed, and the less cost of hospitalization could be reimbursed but not much. With the adjustment of this policy, the economic burden of emergency medical care for residents will be reduced.
which items of reimbursement?
cupping, massage and so on are included in the payment range
from April 1st this year, whether it is the staff medical insurance or the resident medical insurance outpatient service, a batch of diagnosis and treatment projects have been added to 72 items for the first time. For the insured, this is no doubt a good news, which means that the 72 projects that were originally not reimbursed can now be paid through the fund.
reporter noticed that in the overall planning of medical insurance and medical insurance, the new catalogue of diagnosis and treatment projects is the same. According to the relevant people, from Shandong province and Ji'nan City, a problem has been found in the medical practice of the insured persons. Many of the participants recognized the diagnosis and treatment of traditional Chinese medicine, hoping to incorporate the project of TCM diagnosis and treatment into the scope of the overall payment of the fund. "Therefore, this medical insurance part of the policy adjustment, taking into account the local medical habits, the 'pick and treat', 'cut and treat' such as Chinese medicine surgery projects are also included." The personage said.
reporter noted that the 72 new diagnostic items involve detection, examination, diagnosis and treatment of traditional Chinese medicine, new therapies, and so on. For example, brain CT, calcium determination, magnesium determination and other inspection items were included in the general out-patient clinic schedule. New urine routine examination, sediment, occult blood test and bone marrow smear cytology examination were added.
the list of new diagnosis and treatment items, cupping therapy, drug tank, walking canister and so on are listed. According to the relevant people, some middle-aged and elderly participants agree with this kind of therapy. The increase of some projects, such as massage therapy for cervical spondylosis, massage treatment of periarthritis of shoulder, and treatment of lumbar intervertebral disc herniation, has met the needs of more middle-aged and elderly participants. In
72 new items, there are some care for young children, such as children's torticollis massage, atomization inhalation, scalp needle and so on.
in order to reduce the proportion of personal medical expenses, the participants should first choose appropriate medical institutions according to the condition, which is usually said, "the small diseases enter the community and the great disease into the hospital." In addition, when seeking medical advice, we should try to choose medicines and treatment items in the "three directories" of medical insurance.
"three directories" is the abbreviation of the catalogue of drugs, the catalogue of medical treatment items and the scope of medical service facilities. The catalogue of drugs is divided into class A and class B. The expenses arising from the use of category A shall be included in the overall payment and reimbursed according to the prescribed proportion. The proportion of the "category B catalogue" is set up in accordance with the regulations. The cost of the drug is included in the proportion of the insured, and it will be paid as a whole and reimbursed according to the regulations. The list of
diagnosis and treatment projects is divided into three categories, one is that all the costs are included in the overall payment of the project. One is the item that the individual first takes a certain proportion of the cost and then is included in the overall payment range.
medical services facilities mainly refer to the fees related to bed fees.