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山东启动了大病INSU城乡医疗保险制度的整合
2015-11-27 11:26   来源:未知 点击:

济南11月26日(以孙婷婷张旭旭)城乡居民在山东的第一个医疗保险的同类系统的开放融合,城乡居民在同一种健康的享受平等的医疗保健体系保健系统。居民疾病保险制度的不低于50%的统一同步补偿比例实施后,封顶线提高到30万元。

在26日山东省人民政府新闻发布会上居民基本医疗保险制度的运行中,记者了解到,从今年开始,在政策的倾斜,以病人危重病,大病保险的只有20原新型农村合作医疗类疾病补偿,根据补偿整个过渡的量,不再疾病区别开来。累计超过由居民大病保险补偿的一定程度上的个人承担的部分。

按照人均标准32元拨款购买巨灾保险的商业保险机构,全省资本2.3十亿人民币筹集大病保险&。山东省人力资源和社会保障厅副厅长Sunting宇,今年以来,山东省重新招标承办确定居民大病保险的商业保险机构。 居民承办大病保险的盈利能力和成本不超过2%的年筹集大病保险居民的资金总额,由商业保险机构承担的基本医疗保险基金损失的收益部分超过2%。

在除大病保险,报销用药可以扩大居民的范围,农村居民用药品种的整合扩展到2400之前1100种品种。全市一般绝大多数门诊统筹制度的同时实施,扩大门诊慢性病范围,报销比例从56%提高到了预集成的58%。此外,在整个治疗不降低总体原则,并进一步提高了医院的偿还的比例。

居民基本医疗保险实行市级统筹,统收统支的原则和。 Sunting宇介绍,它不会对市场条件,可建立市级调剂金制度,解决方案,调整资金在县不低于20%,目前的基金收入(市,区)的比例。到2017年,所有城市,以实现基金统收统支。

据了解,居民医疗保险制度整合后,山东省实施了市级城市 - 城市投保人可以选择在全省范围内实现联网远程医疗记录整个区域内的医生,医疗费用可即时结算复诊解决了常规转诊难,个别之后提前报销等问题。 (完)

Jinan, November 26 (by Sun Tingting Zhang Xu-xu) open integration of urban and rural residents in Shandong's first medical insurance system of its kind, the urban and rural residents to enjoy equal health care system under the same kind of health care system. Residents illness insurance system after the implementation of a unified synchronous compensation ratio of not less than 50%, cap line raised to 300,000 yuan.

On the 26th Shandong Provincial People's Government news conference on residents' basic medical insurance system for the operation, the reporter learned that, beginning this year, the policy tilt to patient critical illness, serious illness insurance from only 20 original NCMS category illness compensation, according to the amount of compensation for the entire transition, no longer distinguish between disease. Accumulated over a certain amount of personal commitment part compensated by the residents serious illness insurance.

"in accordance with the standard 32 yuan per person allocated funds to purchase catastrophic insurance for commercial insurance agency, the province capital of 2.3 billion yuan to raise serious illness insurance." Shandong Province, Human Resources and Social Security Department deputy director Sunting Yu, this year, Shandong Province to re-tender the contractor determines the residents serious illness insurance commercial insurance institutions. "Residents undertake serious illness insurance profitability and cost no more than 2 percent year to raise total funds of serious illness insurance inhabitants, more than 2% of the portion of the return of the basic medical insurance fund losses borne by the commercial insurance agencies."

In addition to the serious illness insurance, reimbursement of medication can expand the scope of the residents, rural residents expanded from drug varieties integration to 2400 before 1100 kinds of species. The vast majority of the city in general out-patient co-ordinate the implementation of the system at the same time, expand the scope of outpatient chronic diseases, reimbursement ratio increased from 56% to 58% of pre-integrated. In addition, throughout the treatment does not reduce the overall principle, and further improve the proportion of hospital reimbursement.

"Resident Basic Medical Insurance to implement municipal co-ordination, unified revenue and expenditure in principle." Sunting Yu introduced, it will not have the market conditions can be established municipal adjustment fund system, solution adjustment funds on counties (cities, districts) ratio of not less than 20% of current fund revenues. By 2017, all municipalities to achieve the Fund unified revenue and expenditure.

It is understood that after the resident medical insurance system integration, Shandong Province implemented a municipal cities - urban insured can choose a doctor within the overall region in the province-wide implementation of networked remote medical record, medical expenses can be immediate settlement, referral to solve the conventional medical referral is difficult, after the individual to advance reimbursement and other issues. (End)

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