Beijing social security reimbursement rate for major diseases

1, outpatient coordination township and village subsidy ratio increased to 65% and 75% respectively. 2, first-class medical institutions hospitalization costs of less than 400 yuan, there is no starting line; 3, second-class medical institutions to increase the proportion of subsidies to 75% ~ 80%; 4, third-class medical institutions to increase the proportion of subsidies to 55% ~ 60%. 5. The subsidy rate for provincial third-level medical institutions is increased to 55%. 6, children's congenital heart disease and other 8 kinds of major diseases of the new rural cooperative subsidized disease quota of 70%, lung cancer and other 12 kinds of major diseases, the new rural cooperative subsidized disease quota strive to reach 70%. In the event of incurring medical expenses exceeding the maximum payment limit of the basic medical care co-ordination fund, the social insurance department will reimburse 85% of the medical expenses incurred at the following rates: below 0-40,000 yuan; 90% of the reimbursement for the expenses incurred from 40,000 yuan to below 80,000 yuan; 95% of the reimbursement for the expenses incurred from 80,000 yuan; and the maximum payment limit will be 150,000 yuan in each medical year.

For some particularly expensive major diseases, China will set up a supplemental medical insurance reimbursement system, which will reimburse again on top of the reimbursement from the basic medical insurance, and require that the actual reimbursement rate be no less than 50 percent. The National Development and Reform Commission (NDRC), the Ministry of Health, the Ministry of Finance, the Ministry of Human Resources and Social Security, the Ministry of Civil Affairs, the Insurance Supervisory Commission and other six departments have announced the "Guiding Opinions on Carrying Out Major Disease Insurance for Urban and Rural Residents", in order to avoid the phenomenon of poverty caused by illnesses and the return of poverty to the poor. The main points of the new policy of major disease insurance for urban and rural residents: First, the object of protection of urban residents' medical insurance, new rural cooperative insurance participants. Second, the source of funds from the urban residents' medical insurance fund, the new rural cooperative fund, no additional increase in the burden of individual contributions. Third, the standard of protection for patients with annual high medical expenses, more than the local annual per capita disposable income of urban residents in the previous year, the annual per capita net income of rural residents as a criterion for judgment, the specific amount determined by the local government. Fourth, the level of protection insurance actually pay no less than 50%; in principle, the higher the medical expenses, the higher the payment ratio. Fifth, the way the contractor government departments to determine the reimbursement and other policies, through the bidding of commercial insurance organizations selected to undertake. Does not additionally increase the burden of individual contributions it is understood that, at present, there are more than 50 kinds of diseases in China may cause some families to become poor and return to poverty due to illness. The National Development and Reform Commission said yesterday that the development of major disease insurance, urban and rural residents due to suffer from major illnesses incurred high medical expenses to be reimbursed, the purpose is to avoid poverty due to illness, return to poverty due to illness. The object of protection of major disease insurance is the urban residents' medical insurance, new rural cooperative participants, the funds required from the urban residents' medical insurance fund, the new rural cooperative fund, no longer increase the burden of the masses of individual contributions. It has been estimated that the annual per capita disposable income of urban residents or the annual per capita net income of farmers in various places can be used as the standard for catastrophic medical expenses of local families. When an insured patient's personal burden of medical expenses exceeds this standard, it is likely to put the family in financial straits. The major disease insurance reimburses this small group of people for their personal expenses on top of those already reimbursed by the basic medical insurance, and requires that the actual reimbursement rate be no less than 50%. Compliance medical expenses here are not limited to the scope of the basic medical insurance policy, but in order to avoid waste and overburdening, items that are not necessary for basic treatment are not included in the scope of reimbursement. According to the document, the fund of the major disease insurance comes from the balance of the original medical insurance fund, and is handed over to the commercial insurance organization to manage, and take the way of purchasing the major disease insurance from the commercial insurance organization. Undertake the major disease insurance commercial insurance institutions, must operate in China for more than five years of health insurance business; have a comprehensive service network and strong medical insurance professional capacity; equipped with medical and other professional background of full-time service personnel; can realize the major disease insurance business separate accounting and so on. At the same time, to reasonably control the profitability of commercial insurance institutions, and to provide "one-stop" instant settlement services, to ensure that the public conveniently and timely enjoy the benefits of major disease insurance. Beijing situation Beijing is demonstrating "medical insurance supplement insurance" Beijing since 2008, that is, the first in the country to realize the full coverage of the medical insurance system, the medical insurance system has covered all Beijing residents and foreign household registration in Beijing work crowd. For both employee and resident medical insurance, Beijing has established a system of outpatient reimbursement and hospitalization coverage for major illnesses. As for the protection of serious and serious diseases, Beijing is now discussing the establishment of supplementary insurance to solve the problem that some people are still overburdened after the reimbursement of medical insurance. The maximum reimbursement limit for hospitalization medical expenses is currently 300,000 yuan for employee medical insurance, which is the highest medical insurance treatment. However, the cost of treatment for some diseases is relatively high, such as leukemia, kidney dialysis, etc., patients may have to spend millions of dollars. In this regard, Beijing will introduce a policy this year in the hope of alleviating the problem of overburdening insured persons suffering from serious illnesses, especially those in difficult circumstances. Currently, the Beijing Municipal Bureau of Human Resources and Social Security is demonstrating supplementary reimbursement policies for more than 10 major diseases. The preliminary determination of the inclusion of supplemental reimbursement of major diseases, including cancer, leukemia, hemophilia, kidney dialysis.