July 31st, reporters from the Xining Municipal Social Insurance Administration Bureau, according to actual situation of the reform of the basic medical insurance system in Xining City, adjustment of urban workers’ medical insurance, medical insurance for urban residents, the new rural cooperative medical insurance (hereinafter referred to as the basic medical insurance policy), and simplify the handling process, to provide convenience for the insured to pay all kinds of medical expenses. At present, the new policies have been implemented.
five basic medical insurance policy adjustments
The merger of
– the original large relief workers and urban workers to serious illness insurance, workers, retired 40 yuan, individual workers each year to pay 60 yuan fee according to the large relief, multi-channel financing part included in the basic medical insurance fund, financial accounting system in accordance with the relevant provisions.
– urban workers basic medical insurance maximum payment limit, from the current 50336 yuan adjusted to $250 thousand. Where you need to pay back the number of medical insurance contributions are calculated according to the amount of 4.2% of the amount of the amount of payment, the payment period is not a personal account, hospitalization expenses are not reimbursed.
cancel the city, County Social Security Bureau monthly reserve medical institutions to advance the medical insurance for workers, the provisions of the 10% Medicare residents deposit. If the designated medical institutions violations, penalties for illegal expenses will be deducted from the monthly payment of the medical insurance fund.
– in order to improve the efficiency of employee health insurance personal account fund, to better protect the basic medical needs of the insured, the individual account fund use by the extension of medical treatment to prevent disease, based on the original urban workers’ basic medical insurance fund personal accounts scope, the insured can use personal account funds to buy health food approval department the food and drug supervision and management in retail drugstores and grassroots medical institutions (Health), food disinfection (Xiao Wei word) and the management of a class (by means of conventional management enough to ensure its safety and effectiveness of medical devices, medical devices (two) refers to the medical equipment to control its safety should the validity,).
– insured patients outside medical reimbursement of medical expenses (including tolerance, visit relatives, travel in the field of emergency hospitalization expenses of disease), first by the individual self 10% expense adjustment for the individual to self 5% costs, according to Medicare inpatient policy reported. Personal first part of the 5% part of the cost of medical insurance is not included in the scope of reimbursement for serious illness insurance.
simplify five basic medical insurance management process
– cancel the diagnosis and treatment of hospitalized insured patients when medical materials, outside the hospital examination, medical treatment, medical injury transferred overseas shall be prescribed by the original city, County Social Security Bureau for approval or pre filing, all by the designated medical institutions, medical insurance for approval by the designated medical institutions and make registration and filing.
– reduced the insured patients turn foreign medical treatment of medical expenses reimbursement procedures, allow foreign medical reimbursement insured patients more convenient, connected by way of implementing the power and responsibility, the examination and approval to outside fixed-point hospital referral diagnosis right after the diagnosis and treatment of patients can be transferred, transferred by;