Hebei Province recently released the "notice on doing a good job of basic medical insurance for urban residents in 2015," pointed out that from this year onwards, the province's urban residents will be increased by 30 yuan on the basis of last year's individual contribution standard, to no less than 120 yuan per capita. Medical insurance contributions are high, the treatment will also rise, the policy scope of hospitalization costs reimbursement ratio will reach about 75%.
Individual contributions in our province this year rose 30 yuan
In accordance with the provisions of the 2015 Hebei Province, urban residents in Hebei Province, the per capita financial subsidy standard reached 380 yuan, of which the central financial subsidy of 216 yuan, the provincial, municipal and county financial subsidies in accordance with the provisions of the matching ratio of matching subsidies.
Financial subsidy standards have risen, individual contributions have also increased this year. Individual contribution standards for urban residents in 2014 on the basis of an increase of 30 yuan, to a per capita (adults and minors on average) of not less than 120 yuan.
Since medical insurance is currently a municipal level of coordination, the situation varies from district to district. Individual contribution standards have not been reached in the city, to adjust the contribution policy as soon as possible, the implementation of the responsibility of individual contributions.
Based on the actual income and expenditure of the basic medical insurance fund for urban residents and the growth rate of per capita disposable income of urban residents, it is reasonable to formulate a program to increase the individual contribution standard in 2016 and beyond. Shijiazhuang City, the current implementation of the contribution standard is slightly different depending on the population, which is the least college students, 20 yuan per year; working-age insured residents pay the most, ranging from 160 yuan to 280 yuan.
This year's hospitalization can be reimbursed three-quarters of the basic medical insurance principle is "balance of payments, a slight surplus", pay more money, means that the health insurance treatment will also be improved. According to the fund capacity, Hebei Province will be appropriate to adjust the proportion of payment of the integrated fund, tilted to the primary health care institutions, to promote the formation of hierarchical diagnosis and treatment, two-way referral mechanism.
The reimbursement ratio of hospitalization expenses within the policy scope of urban residents' health insurance reached about 75% in 2015. The policy requires that Hebei Province should adjust the health insurance policy for college students in a timely manner to improve the enthusiasm of college students to participate in the insurance. At present, Shijiazhuang City, college students in the school year to participate in the insurance, the annual contribution of only 20 yuan per person.
For the special characteristics of newborns, Hebei Province to develop a reasonable policy, and timely inclusion of urban residents into the scope of basic medical insurance. At present, Shijiazhuang City, newborns can not be subject to the restrictions of the centralized enrollment period, the whole year can apply for enrollment procedures. In accordance with the requirements, Hebei Province, but also continue to do a good job on the "low-income families over 60 years of age and the loss of the ability to work of the elderly and severely disabled people" to participate in the work of subsidies. At present, Shijiazhuang City, this group of individuals do not pay, all the costs required by the government to pay the bill.
This year, the full implementation of the system of major medical insurance urban residents health insurance is to protect the basic, when it comes to major illnesses and serious illnesses to rely on major medical insurance to tide you over.
In accordance with the requirements of Hebei Province this year will be the full implementation of the urban residents of the major disease insurance system, has not yet completed the bidding work of the city, county, to speed up the implementation of the progress as soon as possible to complete the bidding work. At the same time to do a good job of basic health insurance, major medical insurance and medical assistance and other systems of policy convergence and cost settlement services.
Shijiazhuang City since 2013, the first batch of the implementation of the major disease insurance policy, so that the insured residents suffering from serious illnesses more than one layer of protection. So under what circumstances, Shijiazhuang City, who participated in the urban residents of health insurance can be reimbursed for major medical insurance? According to
Introduction, the amount of personal out-of-pocket medical expenses in the starting standard and below, the big disease insurance fund will not pay. If the amount is more than the starting standard, the percentage of compensation will be determined according to the amount of out-of-pocket medical expenses.
At present, the starting standard for urban residents' major medical insurance in Shijiazhuang is 25,000 yuan. That is to say, residents hospitalized in the medical insurance directory to spend the cost of the part of the personal burden of more than 25,000 yuan, you can enter the scope of reimbursement of the big disease insurance. Participants in the provincial capital urban residents' medical insurance, in a settlement year, residents of the maximum limit of 180,000 yuan of major disease insurance benefits. Together with the 120,000 yuan maximum limit of urban residents' basic medical insurance fund payment, the maximum payment limit of urban residents' medical insurance can be up to 300,000 yuan.
The current starting standard and reimbursement ratio of major disease insurance in Shi City
25,000 yuan - 30,000 yuan pay 50%
30,000 yuan - 60,000 yuan pay 53%
60,000 yuan - 90,000 yuan pay 56%
90,000 yuan - 120,000 yuan pay 60%
120,000 yuan - the maximum limit of payment 65%
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