What is the proportion of serious illness insurance in social security?

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The pilot area of serious illness insurance in Baozhong can appropriately increase the flexibility of payment according to the actual situation. The actual payment ratio of serious illness insurance is not less than 50%, and there is no maximum payment limit in principle.

Ministry of Human Resources and Social Security said that the major illness insurance in social security will be gradually pushed forward by the pilot, and there is no maximum payment limit in principle.

Payment items are limited to medical insurance.

On September 17, Ministry of Human Resources and Social Security held a symposium on total payment control of major illness insurance and medical insurance in social security. Hu Xiaoyi, Vice Minister of Ministry of Human Resources and Social Security, said that the serious illness insurance for urban and rural residents is a new thing as an exploration to improve the medical insurance system and innovate public services. All localities will, in light of the actual situation, carry out pilot projects first, conduct phased assessments, sum up experience, and then gradually push them away.

Hu Xiaoyi introduced that to carry out serious illness insurance for urban and rural residents, all localities can refer to the annual per capita disposable income of local urban residents or the annual per capita net income of rural residents to determine the threshold for serious illness insurance. In principle, the drugs and medical treatment items paid by serious illness insurance in social security are limited to the basic medical insurance policy. The pilot areas can appropriately increase the flexibility of payment according to the actual situation. The actual payment ratio of serious illness insurance is not less than 50%, and there is no maximum payment limit in principle.

Measures for assessment of commercial institutions will be introduced.

Hu Xiaoyi introduced that for commercial insurance institutions that introduce serious illness insurance into social security, an assessment method centered on the level of protection and the satisfaction of the insured will be established to reasonably control the profitability of commercial insurance institutions.

In the specific operation, the basic medical insurance and commercial insurance are considered as a whole, and they are connected in various links such as participation, payment, fund distribution, fund financial management, payment settlement and expense audit.

Hu Xiaoyi once stressed that despite the introduction of commercial insurance institutions, the medical insurance policy for serious illness is still the government's public policy. Just relying on market resources, commercial insurance companies are invited to handle it specifically. Its source of funds is allocated from the balance funds of urban residents' medical insurance and the new rural cooperative medical system.