Re: guide to basic medical insurance for urban residents in Ji'nan

Three,
(1)
medical insurance premium standard

(yuan / year) government subsidy
(yuan / year) individual payment
(yuan / year)
school students, children and other
minor towns Residents 100 (125) 60 (75) 40 (50)
elderly urban residents 500 (625) 300 (385) 200 (240)
other adult
urban residents 500 (625),
severe disability,
urban low insurance personnel students, children and other
minor urban residents 100 (125) 100 (125) 0
elderly urban residents 500 (625) 500 (625) 0
other adult
residents 500 (625) 500 (625) 500 (625)
note: the number of parentheses is to raise standards in 2008.
(two) payment period and treatment enjoyment period
October 1st to December 31st (2008 payment period from September 1st to October 31st) for residents' medical insurance premium payment period, from the following year January 1st to enjoy the treatment of medical insurance treatment. From January 1st to December 31st, each year is a medical year (2008 enjoys a period of 15 months from October 1, 2008 to December 31, 2009).
(three) payment method
the medical insurance fee of students and children is charged by the school and the kindergartens in the payment period according to the prescribed standards, and deposit into any business outlets in the designated bank.
after completing the registration procedure for other urban residents, with the "Notice of the payment of basic medical insurance for urban residents of Ji'nan city" in the prescribed payment period, the payment standard will be paid to the business outlets in the designated bank and city according to the standard of payment.
low insurance targets and severe disabled persons are registered in the medical insurance agencies of each district. After the approval of the identity audit, the "Ji'nan city residents' basic medical insurance exemption personnel treatment form" is issued. The relevant personnel according to the "Ji'nan city urban residents basic medical insurance exemption personnel treatment identification form" It is exempt from medical insurance.
four, medical insurance card
municipal medical insurance agency collect the registration information of the insured persons from the medical insurance agencies of each district by the system, and give the card data to the business card dealer, the card maker to produce the card file, and make the medical insurance card unify. The result of the registration card of the medical insurance agency of the city is managed through the system. After the medical insurance card was finished, the medical insurance agency issued the medical insurance card to the insured person through the school, the kindergartens and the street (town) labor security agency.
five, information change and renewal payment
changes in basic information of school students and children, or changes in the category of personnel, should be carried out by the school or the kindergartens, and carry relevant materials to the medical insurance agency of the District of Ji'nan to fill in the application for information change of basic medical insurance personnel of urban residents. The form is to go through the formalities of information change. There is no change in the basic information of the students and children who have been enrolled in the insurance registration, enjoying the treatment and the children. The subsequent annual renewal of the payment will not go through any other procedures, and continue to pay the fees in the school and the kindergartens, and the changes in the personnel category will be paid by the new category after the procedure of change.
other urban residents need to change if the basic information is mistaken or changes in the category of personnel. The relevant materials should be carried to the medical insurance agency of the district to fill in the application form for information change of basic medical insurance personnel of urban residents in Ji'nan, and to deal with the formalities of information change. There is no change in the basic information of other urban residents who have been registered and enjoyed the treatment. In the future, when the annual renewal of the payment, no other formalities will be handled. In the specified payment period, it will be paid directly to the business outlets in the designated bank and the city. If the categories of personnel change, they must be renewed and paid according to the categories of new personnel after the completion of the change procedures.
six, the treatment of the basic medical insurance for urban residents
the urban residents of Ji'nan can enjoy the medical insurance treatment of the corresponding residents after paying the medical insurance premiums in full payment period:
(1) general outpatient treatment. In a medical year, the outpatient medical expenses, which are in accordance with the coverage of the residents' medical insurance fund in the designated community health service institutions, are not more than 200 yuan, and the residents' medical insurance fund is paid in accordance with the standard of 20%. The residents' medical insurance fund will not be paid for the general outpatient expenses outside the designated medical institutions.
(two) hospitalization treatment. The insured residents are hospitalized in a designated medical institution because they are discharged from the hospital. When they are discharged from the hospital, they meet the cost of the coverage of the medical insurance fund of the urban residents. The individual pays only the standard of starting and payment and the expenses to be borne by the individual. The rest is settled by the medical insurance agencies and the designated medical institutions.
(three) stipulate the treatment of disease in the outpatient department. The residents suffer from the following diseases: the treatment of malignant tumor and leukemia, the dialysis treatment of renal failure, the anti rejection treatment of organ transplantation, the outpatient medical expenses of the outpatient treatment in the fixed-point medical institution, which can be paid by the medical insurance fund of the residents according to the prescribed proportion.
(four) compensation for accidental injury of students, children and other urban residents under 18 years of age. Students, children and other insured persons under 18 years of age have accumulated more than 200 yuan in the medical insurance fund of the resident medical insurance fund, which are more than 200 yuan in the medical insurance fund. The maximum payment limit is 2000 yuan (including individuals in a medical year). Part of a certain proportion of the burden).