I come from Yuncheng City, Shanxi Province. I have asthma and take medicine every day. Does the government have a subsidy policy?

Audit and reimbursement of supplementary medical insurance expenses

1. Handling conditions: The insured participating in supplementary medical insurance includes: 1, suffering from 12 chronic diseases: diabetes, hypertension (stage II and III), chronic hepatitis (except hepatitis A), malignant tumor, coronary heart disease, Parkinson's disease, sequelae of stroke (including cerebral infarction, cerebral hemorrhage and subarachnoid space). 2, the overall fund to pay the maximum amount of more than 40 thousand yuan of medical expenses. 2. Go through the formalities: 1. Acceptance: 2. Audit of expenses: (1) In 800 yuan, the proportion of supplementary medical insurance fund payment is 70%, and the maximum payment limit is 2,500 yuan; Over the age of 70, the conceit exceeds that of 600 yuan, and the proportion of supplementary medical insurance fund payment is 80%, with a maximum payment limit of 3,000 yuan. (2) The maximum payment limit of the overall fund is more than 40,000 yuan, and the supplementary medical insurance fund pays 90%, with the maximum payment limit of 6,543.8+0.6 million yuan. 3. financial payment 3. Application materials: 1. Supplementary information to be provided for medical outpatient service 12 chronic diseases: social insurance card (ic card) of the insured, medical insurance medical record card, computer settlement bill and expense list of outpatient medical expenses after personal account is used up, disease certificate issued by the attending physician or above in the municipal hospital and stamped by the medical department, and ID card required for those over 70 years old. 2. Information to be provided for medical expenses with a maximum limit of 40,000 yuan or more: social insurance card of the insured, medical insurance medical record card, computer statement or valid bill for hospitalization or reimbursement, detailed list of medical expenses, bill of payment, discharge summary, supplementary medical insurance payment approval form (exceeding 40,000 yuan for the first time) or letter of introduction from the company (after the second time). Those who enjoy Medicaid for civil servants, regardless of special diseases, will directly return to their personal accounts according to the regulations after the outpatient pays. Other personnel, 12 insured persons with chronic diseases, still need to use ic card to register for medical treatment and settlement after using their personal accounts, and keep the expense list and settlement bills. When the insured applies for reimbursement of supplementary medical insurance after paying the outpatient medical expenses, they need to carry the disease certificate, outpatient medical record, IC card, expense list and all computer bills for paying the outpatient medical expenses in cash issued by the designated hospital, and go to the lobby on the first floor of the municipal social insurance fund management center for review, registration and reimbursement.

In the out-of-pocket expenses of individual medical accounts and the minimum payment standard of supplementary medical insurance (the so-called "threshold fee" of supplementary medical insurance), after the expenses of reported diseases are exhausted, the excess supplementary medical insurance will be partially subsidized. The "threshold fee" for ordinary insured personnel is 800 yuan, which exceeds the supplementary medical insurance fund by 70%, and the maximum payment limit is 2,500 yuan; The self-paid "threshold fee" for retirees over 70 years old is 600 yuan, and the proportion of over-supplementary medical insurance funds is 80%, and the maximum payment limit is 3,000 yuan; Those who enjoy the treatment of model workers at or above the provincial level and the special government allowance of the State Council shall be treated as retirees over 70 years old. (There is no subsidy for 800 yuan or retirees over 70 years old who are paid within 600 yuan, but only after they exceed it).

How to pay and use supplementary medical insurance premiums for employees

Answer: All employers and employees must participate in supplementary medical insurance for employees on the basis of participating in basic medical insurance for employees. Supplementary medical insurance premiums shall be paid by the employer according to 65438+ 0.2% of the total wages of employees last month. ?

The employee supplementary medical insurance fund is mainly used for: First, the maximum payment limit of the fund is more than 40,000 yuan, 90% of the supplementary medical insurance payment, 10% of the individual payment, and the maximum payment limit is10.6 million yuan. 2. Diabetes, hypertension (stage II and III), chronic hepatitis (except hepatitis A), malignant tumor, coronary heart disease, Parkinson's disease, sequelae of cerebral apoplexy (including cerebral infarction, cerebral hemorrhage and subarachnoid hemorrhage), chronic bronchitis (including bronchial asthma), chronic nephritis (including chronic renal insufficiency), rheumatoid arthritis, systemic lupus erythematosus and chronic aplastic anemia. 65438. After the personal medical account is used up, the self-payment threshold of supplementary medical insurance (the so-called "threshold fee" of supplementary medical insurance) is paid in full, and some subsidies will be given to the excess supplementary medical insurance. The "threshold fee" for ordinary insured personnel is 800 yuan, and the proportion of the supplementary medical insurance fund to pay more than 70%, and the maximum payment limit is 2,500 yuan; The self-paid "threshold fee" for retirees over 70 years old is 600 yuan, and the proportion of over-supplementary medical insurance funds is 80%, and the maximum payment limit is 3,000 yuan; Those who enjoy the treatment of model workers at or above the provincial level and the special government allowance of the State Council shall be treated as retirees over 70 years old. ?

How to identify 12 chronic patients?

Answer: Insured persons suffering from 12 chronic diseases need to be certified by doctors at or above the designated hospital and stamped by the medical department of the hospital. Diabetes, hypertension, coronary heart disease, malignant tumor, Parkinson's disease, apoplexy sequelae, chronic bronchitis, chronic nephritis, rheumatoid arthritis, systemic lupus erythematosus and chronic aplastic anemia. ?

● How do people who enjoy supplementary medical insurance benefits seek medical treatment and reimbursement?

Answer: (1) Outpatient expenses are settled. 12 insured persons with chronic diseases still need to use ic cards to register for treatment after their personal accounts are used up. After the expiration of the "threshold fee" for personal care expenses, it is not necessary to register and settle accounts with IC cards, but directly register and settle accounts with cash, and keep compound prescriptions and settlement bills. Insured persons who apply for reimbursement of supplementary medical insurance after paying outpatient medical expenses according to the threshold fee should bring all computer bills of disease certificate, outpatient medical records, IC card, outpatient compound prescription and cash payment of outpatient medical expenses to the social insurance fund management center for review, registration and reimbursement. ?

(2) When the medical expenses for hospitalization and outpatient treatment of special diseases of the insured exceed the maximum payment limit of the employee's basic medical insurance pooling fund, the excess part shall be paid by the individual in cash first, and then to the supplementary medical insurance reimbursement window of the municipal social insurance fund management center, and the supplementary medical insurance payment approval form shall be filled out as required, and the hospitalization or reimbursement computer statement, expense receipt, detailed medical expense statement, discharge summary and other materials shall be provided for registration, review and reimbursement.