medical insurance

Chatter's social development [2011]1/none.

Counties (cities, districts) Human Resources and Social Security Bureau (Labor Security Bureau), Development Zone Management Committee, Political Department, relevant departments directly under the municipal government, all insured units and insured persons:

In order to implement the Notice of Shandong Social Insurance Bureau on Printing and Distributing the Key Points of Social Insurance Management Services in Shandong Province 20 1 1 (Lu Social Security Bureau [201]1) and the Notice of Liaocheng Municipal People's Government Office on Printing and Distributing the Key Work Arrangements of Liaocheng Medical and Health System Reform 20.

First, raise the maximum payment limit of the basic medical insurance fund for urban residents.

According to the per capita disposable income of Liaocheng in 20 10, the maximum payment limit of the basic medical insurance fund for urban residents is adjusted. In a natural year, the maximum payment limit for adult residents is adjusted to 80,000 yuan, and that for minor residents is120,000 yuan.

Two, adjust the basic medical insurance fund for urban workers to pay the proportion.

After adjustment, the proportion of medical expenses incurred by the insured employees during hospitalization included in the scope of payment of the overall fund is as follows:

Classification of urban workers' pooling funds and aid funds

Grading range: level 1 hospital% level 2 hospital% level 3 hospital%

On-the-job retirement

1 Qifubiaozhun-200087% 90% 85% 88% 80% 83%

2 20000.0 1—50000 89% 92% 87% 90% 82% 85%

3 50000.0 1—70000 9 1% 94% 89% 92% 84% 87%

4 70000.0 1—250000 90% 90% 90% 90% 90% 90%

5 250000.0 1— 35% 35% 35% 35% 35% 35%

Three, adjust the proportion of urban residents' basic medical insurance fund payment.

After adjustment, the proportion of medical expenses incurred by insured residents during hospitalization included in the scope of payment of the overall fund is as follows:

Payment classification of adult residents' overall fund

Grading range: level 1 hospital% level 2 hospital% level 3 hospital%

1 Qifubiaozhun -30000.00 65% 60% 55%

2 30000.0 1—80000.00 70% 65% 60%

Graded payment of minor residents' overall fund

Grading range: level 1 hospital% level 2 hospital% level 3 hospital%

1 Qifubiaozhun -30000.00 75% 70% 65%

2 30000.0 1— 120000.00 80% 75% 70%

Four, adjust the employee medical insurance chronic disease outpatient treatment fund payment ratio.

For outpatients with chronic diseases covered by the Fund, 85% of the employees and 90% of the retirees pay the outpatient medical expenses that meet the requirements.

Liaocheng city outside the jurisdiction to meet the requirements of the inspection fee according to the above standards; In accordance with the provisions of the drug and treatment costs, the payment ratio is 5% lower than this city.

5. Linqing City, Chiping County, Dong 'e County and guanxian City, which are included in the municipal overall planning of medical insurance for urban employees, shall be implemented according to the above standards; Counties that are not included in the overall municipal planning can refer to the implementation.

VI. This notice shall be implemented as of August/0/20 1 year.

20 1 1 July 29th, 2008