Preferential social security measures for special care objects

Notice of the Ministry of Civil Affairs, the Ministry of Finance, the Ministry of Labor and Social Security, and the Ministry of Health on Printing and Distributing the Measures for Medical Security for Special Care recipients (Minfa [2007]1KLOC-0/) Civil Affairs Departments (bureaus), Finance Departments (bureaus), Labor and Social Security Departments (bureaus), Health Departments (bureaus), and.

The measures for the medical security of special care recipients are hereby printed and distributed to you, please follow them.

Ministry of Civil Affairs and Ministry of Finance

Ministry of Labor and Social Security Ministry of Health

July 6(th), 2007

Measures for medical security of special care recipients

Article 1 In order to ensure the medical treatment of special care recipients and effectively solve the medical difficulties of special care recipients, these measures are formulated in accordance with the Regulations on Pensions and Preferential Treatment for Soldiers and other relevant provisions.

Article 2 These Measures shall apply to disabled soldiers, demobilized soldiers from rural areas, veterans returning home sick, survivors of martyrs who enjoy state pensions and living allowances, survivors of soldiers who died in the line of duty, survivors of deceased soldiers, and veterans who participated in the war. The term "entitled groups" as mentioned in these Measures refers to other entitled groups except disabled soldiers from Grade 1 to Grade 6.

Article 3 Special care recipients should participate in urban and rural basic medical security systems such as basic medical insurance for urban workers, basic medical insurance for urban residents and new rural cooperative medical care in accordance with the principle of territoriality; Establish a medical subsidy system for special care recipients, and the level of protection should be compatible with the local economic development level and financial affordability to ensure that the existing medical treatment for special care recipients is not reduced; Give preferential medical services and care to the entitled groups.

Article 4 The State shall guarantee the medical expenses of disabled soldiers from Grade I to Grade VI. Disabled soldiers from Grade 1 to Grade 6 participates in the basic medical insurance for urban workers, and on this basis, enjoys Medicaid for entitled groups. The specific measures shall be implemented in accordance with the Notice of the Ministry of Civil Affairs, the Ministry of Finance, and the Ministry of Labor and Social Security on Printing and Distributing the Measures for Medical Security in disabled soldiers (No.2005199).

Fifth other entitled groups employed in cities and towns, to participate in the basic medical insurance for urban workers, according to the provisions of payment. The local government should urge the units where the entitled groups work to pay insurance according to the regulations. It is indeed difficult for the unit, and all localities should help them to participate in the insurance through multi-channel financing.

Article 6 Other urban entitled groups who do not fall within the scope of the basic medical insurance system for urban workers may participate in the basic medical insurance for urban residents in accordance with regulations; Other rural entitled groups will participate in the new rural cooperative medical system. If it is really difficult, the civil affairs department where the entitled groups are located will help them pay the insurance premium through the urban and rural medical assistance fund.

Article 7 Persons who have not participated in the basic medical insurance system for urban workers, urban residents and new rural cooperative medical care, and other entitled groups who have participated in the above basic medical insurance system but have a heavy burden of personal medical expenses, enjoy urban and rural medical assistance and Medicaid for entitled groups.

Article 8 All localities should raise medical subsidy funds for special care recipients through various channels, such as financial budget arrangement, welfare lottery public welfare fund and social donation, which are mainly used for: disabled soldiers medical subsidy for Grade I to VI, giving appropriate subsidies to medical expenses within the prescribed scope, below the minimum deductible line, above the maximum payment limit and paid by individuals; Subsidize the medical expenses for the recurrence of seven to ten old injuries in disabled soldiers, where the unit is unable to pay and there is no work unit; Subsidies will be given to other entitled groups who have not participated in the basic medical insurance for urban workers, the basic medical insurance for urban residents, the new rural cooperative medical system and enjoy the treatment stipulated in the urban and rural basic medical security system.

The central government will give appropriate subsidies to difficult areas with a large number of special care recipients.

Ninth seven to ten disabled soldiers old injury recurrence of medical expenses, has participated in work-related injury insurance, paid by the work-related injury insurance fund; Did not participate in work-related injury insurance, the work is solved by the work unit; Where the unit is unable to pay and there is no work unit, it shall be solved by the local government from the Medicaid funds for the entitled groups.

Tenth entitled groups to medical institutions for medical treatment, priority registration, priority medical treatment, priority drug purchase, priority hospitalization; Support, encourage and guide medical institutions to voluntarily reduce or exempt relevant medical service fees.

Eleventh medical institutions should disclose the priority and preferential medical services provided for the entitled groups; It is necessary to improve and implement various diagnosis and treatment norms and management systems, so as to achieve reasonable inspection, rational drug use and reasonable charges. Designated medical institutions shall provide medical services for special care recipients in accordance with the prescribed drug list, diagnosis and treatment project list and medical service facilities list.

Article 12 The departments of civil affairs, finance, labor, social security and health are responsible for the management and implementation of the medical security work for special care recipients, and all departments should cooperate closely and earnestly perform their respective duties.

Thirteenth civil affairs departments should meet the conditions of entitled groups into the urban and rural medical assistance system; One to six levels of disabled soldiers, no work units, unified procedures to participate in the basic medical insurance for urban workers; Coordinate relevant departments to study and deal with specific problems encountered in medical security work; In accordance with the requirements of budget management, prepare the annual budget of Medicaid funds for special care recipients and report it to the financial department at the same level for review; Take effective measures to ensure that the Medicaid funds for special care recipients are earmarked.

Article 14 The financial department shall reasonably arrange the Medicaid funds for the entitled groups, and strengthen the fund management, supervision and inspection in conjunction with relevant departments. Measures for the administration of Medicaid funds for entitled groups shall be formulated separately by the Ministry of Finance, the Ministry of Civil Affairs, the Ministry of Labor and Social Security and the Ministry of Health.

Fifteenth labor and social security departments should include eligible entitled groups in the basic medical insurance for urban workers and urban residents; Do a good job in the management of medical insurance services for the insured entitled groups, and ensure that the insured entitled groups enjoy the corresponding medical insurance benefits according to regulations.

Sixteenth health departments should include eligible entitled groups into the new rural cooperative medical system; Organize medical institutions to provide quality medical services for special care recipients; Strengthen the supervision and management of medical institutions, standardize medical services, improve service quality and ensure medical safety; Support, encourage and guide medical institutions to formulate relevant preferential service policies and implement quality service measures.

Seventeenth relevant units, organizations and individuals shall truthfully provide the required information, and actively cooperate with the investigation and verification of the medical security work of the entitled groups.

Article 18 The departments of civil affairs, finance, labor and social security and health of all provinces, autonomous regions and municipalities directly under the Central Government shall, in accordance with these measures and in light of local conditions, formulate specific implementation measures to effectively ensure the implementation of medical treatment for special care recipients. Special care recipients with dual or multiple identities enjoy medical treatment in accordance with the principle of "the highest priority".

Article 19 The term "retired personnel" as mentioned in these Measures refers to those who joined the army after 1 954 65438+1October1,participated in military actions to resist foreign aggression, complete the reunification of the motherland, defend the territorial and sovereign integrity of the country, and defend national security, and have no work units in rural areas and towns and have difficulties in family life since their retirement.

Article 20 These Measures shall be interpreted by the Ministry of Civil Affairs in conjunction with the Ministry of Finance, the Ministry of Labor and Social Security and the Ministry of Health.

Article 21 These Measures shall be implemented as of August 6, 2007.

Notice of the Ministry of Civil Affairs, Ministry of Human Resources and Social Security, the Ministry of Health and the Ministry of Finance on Further Strengthening the Medical Security for Special Care recipients (No.2008152)

Minfa [2008] 152 No.

All provinces, autonomous regions and municipalities directly under the central government, the Civil Affairs Department (bureau), the Labor and Social Security Department (bureau), the Health Department (bureau) and the Finance Department (bureau), the Civil Affairs Bureau of Xinjiang Production and Construction Corps, the Labor and Social Security Bureau, the Health Bureau and the Finance Bureau:

Over the past year, the Ministry of Civil Affairs, the Ministry of Finance, the former Ministry of Labor and Social Security and the Ministry of Health have issued the Notice on Printing and Distributing the Measures for Medical Security for Special Care recipients (Minfa [2007]1KLOC-0/No.,hereinafter referred to as the "Measures"), all regions and departments have conscientiously implemented and solidly promoted the medical security work for special care recipients. Most provinces, autonomous regions and municipalities directly under the Central Government, However, from the national situation, there are still problems such as uneven progress in regional work, insufficient specific supporting policies, simple service procedures and insufficient capital investment. In order to fully implement the guiding spirit of the central leading comrades on "implementing the existing policies to solve the current problems and speeding up the improvement of the legal system to solve the long-term problems" and further strengthen the medical security work for the entitled groups, the relevant matters are hereby notified as follows:

First, speed up the work progress and introduce implementation measures in time.

All localities should formulate specific implementation measures according to the requirements of these measures and the actual situation in the region. Before the end of September 2009, it is necessary to establish and improve the policy system in general, and effectively guarantee the implementation of medical treatment for special care recipients. All localities should further enhance their sense of responsibility and urgency, take effective measures, accelerate the pace of implementation, and earnestly grasp, grasp and grasp this work. The formulation of provincial implementation measures should be completed before the end of 2008 in principle; City (state) level implementation measures shall be formulated in principle before the end of March 2009; The formulation of county-level implementation measures should be completed in principle before the end of September 2009. Where the implementation measures have been introduced, it is necessary to further improve relevant policies, clearly implement measures, and enhance the pertinence and effectiveness of the work. If the work target cannot be completed on time, the civil affairs department shall report the situation step by step in conjunction with the labor and social security, health and finance departments, and explain the reasons. Provincial civil affairs departments shall, jointly with relevant departments, do a good job in deployment and supervision, and report the implementation methods, capital investment and system construction progress at all levels in the region in a timely manner. The Ministry of Civil Affairs shall, jointly with relevant departments, regularly report.

Two, clear mission objectives, to ensure that the entitled groups seek medical treatment.

Relevant local departments should cooperate closely, conscientiously perform their respective duties, and ensure that entitled groups participate in the basic medical insurance for urban workers, the basic medical insurance for urban residents or the new rural cooperative medical system in accordance with the principle of territoriality. The civil affairs department shall go through the formalities of participating in the basic medical insurance for urban workers in disabled soldiers without a work unit, and do a good job in helping the needy people to participate in the basic medical insurance for urban residents and the new rural cooperative medical care in conjunction with the departments of labor security, health and finance. It is necessary to ensure that the entitled groups enjoy urban and rural medical assistance and Medicaid in accordance with the regulations on the basis of enjoying the corresponding basic medical security benefits. All localities should guide medical and health institutions to formulate specific preferential medical services and care policies for the entitled groups in accordance with local relevant regulations, and give priority to the entitled groups in the service links of registration, medical treatment, medicine taking and hospitalization. Through various measures, such as reimbursement of social basic medical security system, medical subsidies for entitled groups, and preferential relief for medical institutions, the existing medical treatment for entitled groups will not be reduced, and the treatment for the same category of entitled groups will be roughly equivalent, and the level of medical treatment for entitled groups will adapt to the local economic and social development level.

Three, increase investment, to provide financial support for the medical security work of special care recipients.

All localities should further increase investment, broaden financing channels and ease the contradiction between supply and demand of funds in accordance with the requirements of the Notice of the Ministry of Finance, the Ministry of Civil Affairs and the former Ministry of Labor and Social Security on Relevant Issues Concerning the Use and Management of Medicaid Funds for Special Care recipients (Caishe [2008] No.35). The local financial departments should include the medical security funds for the entitled groups in the financial budget, make overall consideration at the same time, reasonably arrange the medical security funds for the entitled groups, and give necessary support to related work. Financial departments at all levels should increase their inclination to the difficult areas with a large number of entitled groups at lower levels when arranging Medicaid funds for entitled groups. In addition, all localities should reasonably arrange some funds from the lottery public welfare fund used by the civil affairs department for medical security of special care recipients. Further standardize the management of the use of funds, earmarking; Local civil affairs departments should, jointly with relevant departments and combined with civil affairs statistics, timely and accurately report the progress data of medical security for entitled groups, such as the number of entitled groups enjoying various medical security and the distribution of Medicaid funds for entitled groups. The effectiveness of local work will be an important factor for the Ministry of Finance and the Ministry of Civil Affairs to allocate Medicaid funds from the central government.

Four, simplify the operating procedures, as far as possible to facilitate the special care recipients to see a doctor.

Local civil affairs, labor and social security, health, finance and other relevant departments should strengthen coordination and cooperation, realize the enjoyment of information on medical expenses of entitled groups, reduce settlement links as much as possible according to the principle of convenience and speed, simplify operating procedures, and implement "one-stop" settlement service for medical expenses of entitled groups. The non-personal self-paid part of the medical expenses of the entitled groups should be settled synchronously at the end of their medical treatment; For the special care recipients suffering from critical diseases, it is necessary to implement pre-medical rescue measures such as medical treatment first and settlement later.

Five, unify thinking, raise awareness, and effectively strengthen the leadership of medical security work.

Medical security for special care recipients is an important work that benefits the revolutionary heroes. All localities should fully understand the importance and urgency of doing a good job in this work from the perspective of studying and practicing Scientific Outlook on Development and building a harmonious socialist society, and put accelerating the construction of the medical security system for special care recipients on the important agenda. Civil affairs, labor and social security, health, finance and other departments at all levels should further improve and implement policies and measures for medical security for special care recipients in accordance with the principle of territorial management and their respective responsibilities. All localities should strengthen the construction of grass-roots special care teams, often carry out business training, theoretical discussion and experience exchange, and constantly improve service management capabilities. It is necessary to comprehensively use administrative and legal means to manage and supervise the medical security work for special care recipients, meet the different medical needs of various special care recipients, and promote the healthy development of medical security work for special care recipients.

Ministry of Civil Affairs, Ministry of Human Resources and Social Security, Ministry of Health and Ministry of Finance

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.