What does it mean to subsidize large medical expenses?

Large medical expenses subsidy is a kind of supplementary medical insurance established by the government for the insured of basic medical insurance for urban workers, aiming at subsidizing the part of the insured whose annual medical expenses exceed the maximum limit line.

The large medical expenses subsidy for employees is a medical subsidy method adopted by various localities to solve the large medical expenses above the capping line in the process of promoting the reform of the basic medical insurance system.

Insurance premiums are generally raised by each employee paying a certain fee every year. Social insurance agencies set up large medical expenses subsidies, which are managed and accounted for separately from the basic medical insurance fund. The medical expenses incurred by the insured workers above the capping line shall be paid by a large amount of medical expenses subsidies according to a certain proportion.

The payment standard of large Medicaid is:

1, the employer pays 48 yuan for each insured person every year, and the insured person pays 48 yuan every year. Large medical expenses subsidies should be guaranteed once a year. The employer and the insured shall pay the annual large medical expenses subsidy in full before June 30 each year. Failing to pay on time or in full, you may not enjoy the large medical expenses subsidy in that year;

2, the insured in a natural year, hospitalization basic medical expenses exceed the maximum payment limit of basic medical insurance, the diagnosis and treatment items, service facilities standards, the scope of medication in line with the relevant provisions of the basic medical insurance, by large medical expenses subsidies to pay percent, the individual pays percent. The annual cumulative maximum payment limit of large medical expenses subsidy is 6.5438+0.5 million yuan;

3, the insured special disease outpatient treatment and hospitalization ended, the basic medical expenses exceed the maximum payment limit of basic medical insurance, included in the scope of large medical expenses subsidies, belonging to the individual pays part, settled by individuals and medical institutions, belonging to the large Medicaid payment part, by medical institutions according to the basic medical insurance settlement provisions to the social insurance agencies to declare settlement;

4, large medical expenses subsidies, implemented once a year. The employer and the insured shall pay a large amount of Medicaid in full before 30+0 of 65438 every year. The starting and ending time of enjoying large medical expenses subsidies is calculated according to the natural year. In the medical insurance computer management system, the payment information of large medical expenses will be blocked from 24: 00 on February 3 1 day every year, and will be unlocked after the new insured pays large medical subsidies in full.