What is the standard of social security payment in Xuzhou in 2023?

Recently, the Municipal Finance Bureau, together with the Municipal Medical Insurance Bureau and other three departments, jointly issued the Notice on Adjusting the Financing and Treatment Standards for Urban and Rural Residents' Basic Medical Insurance, adjusting the payment standards for residents' medical insurance participation, comprehensively improving the level of treatment guarantee, further consolidating and improving the basic medical insurance system for urban and rural residents, and improving the financing operation and treatment guarantee mechanism.

First, raise the financing standard.

From 2023, the individual payment standard for ordinary residents is 380 yuan per person per year, and the individual payment standard for college students is 280 yuan per person per year. Financial subsidies shall be subject to the standards set by the state and the province. Medical assistance objects to participate in the basic medical insurance for urban and rural residents in the city's individual contributions, fully funded by the medical assistance fund.

Two, improve the city's outpatient special treatment.

In a co-ordination year, the Qifubiaozhun for special patients is the same as that for hospitalization in tertiary medical institutions. The reimbursement ratio is paid according to the hospitalization reimbursement ratio corresponding to the level of medical institutions, and the purchase of medicines by Class A pharmacies is implemented according to the hospitalization reimbursement ratio of tertiary medical institutions. Qifubiaozhun for patients with two or more special diseases shall be calculated together. The tutor and the inpatient share the annual payment limit.

Serious mental disorders and mental illness in consolidation period are paid according to the disease type, and the settlement standard is 300 yuan and 280 yuan per person per month, which is paid in full by the medical insurance fund, and individuals do not pay; If there is no condition to collect and pay by disease type, you can pay by project, and there is no qifubiaozhun.

Three, adjust the general outpatient Qifubiaozhun.

The basic medical institutions that implement zero-difference sales of drugs have no Qifubiaozhun for general outpatient service, and the Qifubiaozhun for other basic designated medical institutions is 30 yuan.

Four, clear medical assistance quota funds, by the insured rescue Qifubiaozhun.

The qifubiaozhun of the insured objects in our city (including the low-income people who originally established the card during the transition period) is temporarily set to 0. If there are new regulations in the country and province, the new regulations shall prevail. Medical assistance objects participating in employee medical insurance shall be implemented with reference.

Five, adjust the concept of outpatient and inpatient payment limit

According to the requirements of the national and provincial medical insurance diagnosis and treatment catalogue, the meaning of the concept of outpatient and inpatient payment limit in our city has been adjusted from "pooling fund payment limit" to "medical expenses limit within the policy scope".

The maximum payment limit of medical expenses within the scope of an overall annual outpatient policy is 1.200 yuan, and the number of participants included in the management of family doctor contract service is increased to 1.800 yuan.

The maximum payment limit of medical expenses for patients with hypertension and diabetes within the scope of an overall annual outpatient policy is 2000 yuan, and the outpatient service for patients with hypertension and diabetes will be raised to 2400 yuan.

The maximum payment limit of medical expenses (including outpatient medical treatment) within the scope of the insured's overall policy for one year is 250,000 yuan.