Ji 'nan 2022 Social Security Payment Standard Table

All districts and counties (functional areas) medical security departments, financial departments, tax departments, municipal medical insurance centers and municipal medical insurance fund audit centers:

In order to further improve the basic medical insurance system for residents in our city (hereinafter referred to as residents' medical insurance), with the consent of the municipal government, some policies on residents' medical insurance in our city are adjusted as follows:

First, since the payment period of 2022, the individual payment standard for adult residents will be adjusted from 340 yuan to 360 yuan per person per year, and the individual payment standard for children will be adjusted from 240 yuan to 300 yuan per person per year. The individual payment standard of financial aid for college students remains unchanged, and it is still 240 yuan.

2. Since the medical year of 2022, the minimum payment standards for hospitalization expenses incurred by the insured in a medical year within the scope of fund payment are: tertiary medical institutions 1000 yuan, secondary and primary medical institutions in 400 yuan, community medical institutions and township hospitals in 200 yuan. Within a medical year, the threshold for the second hospitalization is reduced by 50%, and the threshold is not calculated from the third hospitalization. The hospitalization expenses incurred by the insured in the designated medical institutions of traditional Chinese medicine within the scope of fund payment, Qifubiaozhun reduced by 20% on this basis.

Three, since the medical year of 2022, the insured person in the province (Ministry) three-level medical institutions in hospital or outpatient treatment of chronic and special diseases, the proportion of fund payment increased from 45% to 50%.

Four, since the medical year of 2022, the funding standard of residents' medical insurance general outpatient fund has been raised from 60 yuan to 75 yuan per person per year. In a medical year, the medical expenses incurred by the insured in the general outpatient department and the expenses paid by the general outpatient fund (excluding the personal burden) are calculated cumulatively. The maximum payment limit for college students was raised from 500 yuan to 600 yuan, and the maximum payment limit for children and adult residents was raised from 400 yuan to 500 yuan.

Five, since the medical year of 2022, in line with the national family planning policy of the insured in the designated medical institutions within the scope of the fund to pay for medical expenses, the implementation of a one-time payment of the fund quota. The abortion rate increased from 150 yuan to 350 yuan, the induced labor rate and natural delivery rate increased from 165438 yuan to 1350 yuan, and the vaginal delivery rate increased from 65438 yuan.

Six, since the medical year of 2022, the insured who are included in the management of chronic diseases and special diseases in outpatient department will be determined to see a doctor at designated medical institutions 1 time, and it can be changed within the next medical year.

Seven, since 2002 1, 10,1,the insured need to be hospitalized in different places, there is no need to go through the procedures of referral and transfer. Residents' medical insurance fund payment is implemented according to the standards of provincial (ministerial) level three-level medical institutions, and the relevant policies for resettling personnel in different places remain unchanged. The fund payment ratio of hospitalization compliance medical expenses incurred by college students participating in insurance in different places is consistent with that of medical treatment in the city.

Eight, since July 3, 20021year, tuberculosis, chronic viral hepatitis and cirrhosis will be included in the scope of chronic diseases and special diseases in residents' medical insurance outpatient service, and the management service requirements such as bidding and auditing standards will be implemented in accordance with Lu Medical Insurance [20021] No.26 document, and the fund payment ratio of medical institutions at all levels will be unified at 60%. Insured persons suffering from tuberculosis, chronic viral hepatitis and cirrhosis can choose designated medical institutions to treat the corresponding diseases, and the number of medical institutions corresponding to each disease shall not exceed1; If the above-mentioned insured persons suffer from other chronic diseases and special diseases at the same time, they can choose 1 designated medical institutions for diagnosis and treatment.

IX. Since July 3, 20021year, anticoagulation therapy after coronary artery bypass grafting has been included in the scope of chronic diseases and special diseases in residents' medical insurance clinics, and relevant management measures are implemented with reference to anticoagulation therapy for coronary heart disease or cerebral infarction.