What does the recently launched "family-based medical insurance" mean?

Chengdu 1 June1Recently, a new method of basic medical insurance for urban residents was introduced to achieve full coverage of medical insurance.

After being identified as a pilot city of basic medical insurance for urban residents in China, in order to achieve full coverage of medical insurance, before June 10 this year, Chengdu will issue supplementary regulations to supplement and improve the Interim Measures for Basic Medical Insurance for Urban Residents in Chengdu, lower the payment standard and change the participation mode.

The payment standard will be lowered.

"After the announcement of the news on the 24th, we immediately began to supplement and improve the policy according to the overall requirements of the country." According to reports, the new supplementary provisions will lower the payment standard, and the individual insurance mode will be changed to family insurance. At present, the payment and treatment of the new scheme are being calculated, which was formally introduced in September and implemented in June at 65438+ 10/.

At present, in the Interim Measures for Basic Medical Insurance for Urban Residents in Chengdu, the payment standard for urban residents in five districts and high-tech zones in Chengdu is 5% of the average salary of employees in Chengdu last year, and 4% in other districts (cities) and counties. The new supplementary regulations will consider lowering this value and lowering the "threshold" so that more residents can enjoy the benefits brought by medical security. In addition to local financial subsidies, the central government will also give corresponding subsidies in the next step.

Insure on a family basis.

At the same time, the mode of participation will be changed to family. Practice shows that in the past, most of the insured people were elderly people, which is not conducive to the cultivation of young people's sense of hardship and "full coverage". After the introduction of the new policy, residents will be insured on the basis of household registration. There are 1 residents and 1 residents, and two residents will be insured. Old people are no longer allowed to participate in insurance, and young people are not allowed to participate in insurance.

On June 65438+1 October1last year, Chengdu launched the pilot work of basic medical insurance for urban residents in three districts (cities) and counties. In June this year, 65438+ 10 1, the Interim Measures for Basic Medical Insurance for Urban Residents in Chengdu was officially implemented, which marked that Chengdu has basically established a medical insurance system covering urban and rural areas, and Chengdu has become the only sub-provincial city in China to establish a medical insurance system for residents and the first provincial capital city to achieve full coverage of the basic medical insurance system.

College students are included in medical insurance.

In addition, in view of the fact that Chengdu's basic medical insurance has not covered college students, special policies will be formulated this year to enable college students to enjoy medical security. At present, the medical insurance policy for college students is also being formulated, and the general direction is similar to the mutual fund for children's hospitalization in Chengdu. It is expected to be submitted for approval at the end of August or early September.

According to a survey, there are 70,000 college students in Chengdu's municipal colleges and universities, and they are expected to enjoy medical insurance by paying tens of yuan every year.

The annual payment of medical insurance for urban residents in six pilot cities in Guangdong does not exceed 300 per person.

2007-07-29 09:59:25

Medical insurance for urban residents in China will be rolled out one after another, and 79 cities have been identified for pilot projects. How is the progress in Guangdong? The reporter learned from relevant authoritative sources yesterday that the relevant scheme in Guangdong has basically taken shape and will be officially announced after further improvement. Each insured person shall pay no more than 300 yuan every year. At present, Guangdong has identified Meizhou, Zhanjiang, Jieyang, Shaoguan and Huizhou.

Six cities in Guizhou and Zhaoqing were used as pilots.

All primary and secondary school students are included.

It is understood that the medical insurance plan to be implemented soon will cover urban registered residents who are not covered by the basic medical insurance system for urban workers, including primary and secondary school (vocational high school, technical secondary school, technical school) students, children, college students who do not enjoy free medical care and other non-employed urban residents. Except for college students, other relevant urban residents, including primary and secondary school students, are insured and paid by their families.

Pilot cities implement low payment rates.

In addition, the pilot work to be carried out soon will start from a low level, with low rates and appropriate subsidies from the government. In the scheme, each person's annual payment does not exceed 300 yuan, and the financial department gives the insured a subsidy (this year's standard is the provincial financial subsidy of 35 yuan, and the city and county subsidies are not less than 15 yuan). For low-income residents or special groups with severe disabilities, the government will fully subsidize them to solve the problem that special groups cannot afford to pay.

In addition, the new medical insurance model will also adhere to the overall planning of serious illness, without personal accounts. The focus of the security is the medical expenses for hospitalization and outpatient serious illness, and the payment ratio will be between the urban workers' medical insurance and the new rural cooperative medical system. In terms of payment ratio, it is inclined to primary medical institutions. Judging from the calculation of the pilot cities to be launched soon, the top line can reach 40,000 to 50,000 yuan a year, and the low line can reach 1 10,000 yuan, depending on the local economic situation.

Urban medical insurance focuses on community implementation.

According to reports, the administrative department of labor and social security will explore the guiding mechanism of linking the payment period with the treatment level, and strive to realize that "the longer the insurance period, the more treatment you enjoy." The insurance work will focus on community implementation, give full play to the advantages of township or street labor and social security service institutions, and provide convenience for the insured to go through the procedures of qualification identification, registration and insurance.

To carry out medical insurance for urban residents, it is necessary to reflect the individual wishes of residents. Will there be a large-scale situation of "insured with illness and surrendered without illness"? According to the analysis of relevant experts, due to the great attraction of the policy, a relatively low payment level can provide greater protection, and the government also has subsidies, which can be borne by ordinary urban families, so the moral hazard should be small.

Guangzhou plans to cancel the old-age insurance for flexible personnel.

We are now soliciting public opinions.

The Measures for the Implementation of Basic Old-age Insurance for Private Enterprise Employees and Individual Industrial and Commercial Households in Guangzhou (hereinafter referred to as the Measures), which has been implemented for 9 years, may be abolished soon.

Yesterday, the Guangzhou Municipal Bureau of Labor and Social Security issued a notice on soliciting opinions and abolishing the Measures for Soliciting Opinions from the Public.

It is reported that the "Measures" came into effect on 1 June 65438+July1September 1998, stipulating that private enterprise owners and individual industrial and commercial households should pay endowment insurance premiums according to the average monthly salary of employees in the previous year, and at the same time stipulated relevant rules. With the adjustment and improvement of the endowment insurance policy by the state and provincial governments in recent years, the notice issued has covered the contents of the Measures. Therefore, Guangzhou Municipal Bureau of Labor and Social Security intends to request the municipal government to abolish it.

Time: July 20th to August 19.

Address: Pension Insurance Department of Guangzhou Labor and Social Security Bureau

Tel: 835 10 1 19.

Fax: 8335 1648

Postal code: 5 10030

E-mail :ylc@gzlabour.gov.cn

1 1 in the morning, the collection and payment of medical insurance for urban residents in Haikou was fully launched, and 15 1 payment points were set up in four districts of Haikou to centrally handle medical insurance payment for urban residents.

At 9: 00 am yesterday, reporters saw in Dayuan Community, qiongshan district City, Haikou City and Qianjia Community, Bailong Street, Meilan District, Haikou City that residents' enthusiasm for participating in medical insurance was very high. According to the staff of Haikou Social Security Bureau, Haikou started the basic medical insurance for urban residents in July 1, and the main participants are those who have not participated in the employee medical insurance and the new rural insurance at present, with a total of 470,000 people in the city.

According to the relevant regulations, urban residents in Haikou City who meet one of the following five conditions can apply for insurance registration: unemployed urban residents with non-agricultural household registration under 60 years old who are over 60 years old 18 years old (including 18 years old); Non-agricultural registered residents over 60 years old (including 60 years old) who have not participated in the basic medical insurance for urban workers; Primary and secondary school students with non-agricultural household registration in Haikou (including students from technical schools and vocational schools); /kloc-children (including infants) under the age of 0/8 who are not in school; Students under the age of 18 who have non-agricultural household registration in Haikou and are studying in primary schools, junior high schools, senior high schools and special schools in other places.

From July 1 day to August 3 1 day, 57 payment points of neighborhood committees and towns in the whole city1day are open to residents to collect premiums. Residents can also pay fees at the Agricultural Bank and Haikou Social Security Local Taxation Bureau. Adult insured persons pay 70 yuan every year; Individual contributions of minors pay 40 yuan premiums every year; Urban residents and urban entitled groups who have not participated in the basic medical insurance for urban workers are fully subsidized by the government.

Practical information question and answer

Q: How to participate in basic medical insurance?

Answer: Urban residents should go to the labor security management station of their community (neighborhood committee) with their household registration book to register and pay fees (subsistence allowances, special care and disabled people need to show relevant certificates). Everyone in the family who meets the conditions for insurance must be insured and cannot be selectively insured.

Q: If I miss this payment time, when can I apply for insurance?

A: Individual residents (families) pay the fee regularly once a year.

In 2007, the payment time is set at July-August, and residents will enjoy medical insurance compensation from September 1. Since 2008, the annual payment time is from 10 to 12, and residents can enjoy medical insurance compensation from 1 the following year. Failing to go through the formalities of insurance within the time limit, and failing to go through the formalities of surrender after insurance.

Q: How many payment methods are there?

Answer: You can pay in cash or collect it at the designated outlets of Agricultural Bank of China.

Q: Where can I apply for reimbursement?

Answer: Insured residents shall go to the labor security centers in various districts (social insurance agencies stationed by Haikou Social Insurance Bureau in various communities) to go through the reimbursement procedures as required.

Detailed rules for the basic medical insurance for urban residents in Xuzhou were issued.

2007-08-06 13: 12:53

Large, medium and small

Label: Health/Health Care

Starting from this month, the city will fully implement the basic medical insurance system for urban residents in Xuzhou, and gradually realize the goal of all urban residents in Xuzhou enjoying basic medical insurance. In order to guide the insured to participate in insurance in time, seek medical treatment smoothly and settle accounts in full, the municipal labor and social security department recently issued the "Detailed Rules for the Participation of Urban Residents' Basic Medical Insurance in Xuzhou".

Be underwritten by insurance

Prepare the materials first

Residents must take out insurance on a family basis. The insurance registration institution is the community labor security service institution where the resident's household registration is located.

When applying for insurance registration, you should bring the following documents (originals and photocopies): household registration book, ID card, employment registration card (below female 18, not required for urban residents over 55 years old and over 60 years old), and two 1 inch color photos with the same edition.

Special subsidy groups such as low-income households, poor workers, severely disabled people, one-child families, and widowed elderly people, in addition to the above-mentioned documents, also need to carry the Xuzhou City Residents' Minimum Living Guarantee Certificate, the Xuzhou City Poor Workers' Certificate, the People's Republic of China (PRC) Disabled Persons' Certificate, the One-child Parents' Honor Certificate, and the Widowed Old People's Certificate issued by the community where the household registration is located (audited by the office) (original and photocopy).

How to deal with it

Insured residents in the community labor and social security service institutions to receive the "registration form" and truthfully fill in, after the audit is correct, will be issued "Xuzhou urban residents' basic medical insurance card, calendar, card fee payment form". After the insured residents pay the fees, they will receive the "Xuzhou Urban Residents' Basic Medical Insurance Certificate", "Xuzhou Urban Residents' Basic Medical Insurance Medical Record" and "Xuzhou Urban Residents' Basic Medical Insurance Certificate".

Insured residents hold the "Xuzhou Urban Residents' Basic Medical Insurance Certificate" to the designated payment bank to pay the residents' basic medical insurance premium. After payment, you will start to enjoy insurance benefits on 1 day next month.

The detailed rules also clearly stipulate that the payment can be renewed, and residents can pay directly at the designated bank at 10+before October 30th every year. Special subsidy groups, such as low-income households, destitute workers, orphans, widowed old people, etc., can pay the insurance premium for the next year in the bank only after going to the community labor and social security service institution where they are registered for annual review from September 1 day to1October 3 1 day.

Matters needing attention

Failing to pay residents' medical insurance premiums in full and on time, stop enjoying residents' medical insurance benefits; Within 3 months (including 3 months), the insurance benefits can only be restored after the arrears and late fees are paid. Since July 2007 1 the implementation date of the basic medical insurance for urban residents in our city, urban residents who meet the scope of insurance coverage and have not paid the insurance premium before June 30, 2008, and have been suspended for more than 3 months, can enjoy medical insurance benefits according to the newly insured residents after paying the insurance premium.

to be hospitalized/be admitted to hospital

Premise:

Designated medical institutions follow the principle of convenience and voluntariness, and the insured residents can choose independently. Each insured resident must choose 1 designated community health service institutions, and can choose 1 designated secondary and tertiary medical institutions. Insured children can add a general hospital or children's hospital with pediatric inpatient ward as the designated medical institution for reimbursement of children's outpatient service.

Outpatient medical process

Insured residents must be in the designated community health service institutions when visiting the outpatient clinic, otherwise the medical expenses incurred will not be paid by the overall fund.

Insured children can go to the designated community health service institutions and children's outpatient clinics, and the medical expenses incurred are included in the scope of outpatient payment of the overall fund.

Insured residents to residents' medical insurance, calendar, card to the selected designated community health service institutions for outpatient treatment.

Designated community health service institutions carefully identify residents' medical insurance, calendars and cards by "swiping cards" one by one. If the patient is found to be inconsistent with the medical insurance certificate, he should refuse to swipe his card.

Insured residents see a doctor according to the outpatient diagnosis and treatment procedure.

Designated medical institutions shall standardize the writing of outpatient medical records, prescriptions and other medical documents.

Insured residents with doctor's prescription, examination and treatment application form and other credit cards, according to the provisions of the settlement.

Hospitalization process

Insured residents hold residents' medical insurance cards, calendars, cards and the Notice of Hospitalization, and go through hospitalization procedures at the inpatient department of the designated medical institution.

Designated medical institutions will carefully identify medical insurance vouchers, calendars and cards one by one when handling hospitalization procedures for insured residents. If it is found that the identity of the medical practitioner does not match the medical guarantee, it shall refuse to swipe the card.

Insured residents need to pay a certain amount of deposit to pay medical expenses that need to be paid by individuals.

After going through the admission formalities, the medical insurance certificate and calendar of the insured residents shall be handed over to the designated medical institutions; Its medical insurance card automatically enters the "hospitalization lock card" state.

When leaving the hospital, the patient or the agent will look at the Detailed List of Expenses of Residents' Medical Insurance Discharged Patients in detail, settle the hospitalization expenses, settle the deposit at one time, recover the medical insurance voucher and calendar, and sign the Detailed List of Expenses of Residents' Medical Insurance Discharged Patients (in triplicate, one for the patient).

After going through the discharge formalities, the medical insurance card will automatically enter the state of "discharge card cancellation".

Family sickbed medical process

Patients with advanced malignant tumor (non-radiotherapy and chemotherapy); Patients with cerebrovascular accident in rehabilitation period; Patients with ascites due to cirrhosis without other serious complications; Fracture patients who need bed rest and traction fixation; Chronic obstructive emphysema; Alzheimer's patients; People over 70 years old (excluding 70 years old) with chronic diseases need continuous treatment. Family conditions are suitable for examination, treatment and nursing, life can't take care of themselves, it is difficult to be hospitalized in designated medical institutions, and insured patients who need regular home treatment (excluding those who seek medical treatment in different places) can apply for family beds.

In principle, a treatment cycle of family sickbed should not exceed 2 months, and it needs more than 2 months. Designated medical institutions shall be reported to the municipal medical insurance agency for examination and approval, but the longest period shall not exceed 3 months.

If you need to stay in a family bed due to illness, you should reapply. The same insured patient can't be hospitalized more than 2 times in one overall year.