The medical aid for major illnesses refers to a new type of medical aid system that relies on the settlement platforms of urban residents' (employees') basic medical insurance and new rural cooperative medical care, and has stable financial inputs, service platforms*** use, information resources*** enjoyment, synchronization of settlements and payments, standardized management and operation, and obvious aid effects, and is able to provide fast services for the needy, and covers both urban and rural areas in a scientific and standardized manner. So what are the policies and regulations of Beijing's major disease assistance? What is the reimbursement ratio and reimbursement scope of Beijing's major medical assistance? The following content is for reference only!
The object of application for Beijing's major medical assistance: Beijing household registration or holders of Beijing residence permit.
(1) Difficult families
Due to fire, traffic accidents and other accidents, family members of the sudden major diseases, encountered unexpected events, resulting in the basic life of the family temporarily serious difficulties;
Due to the sudden increase in the expenditure of living necessities beyond the family's ability to bear, resulting in the basic life of the temporary serious difficulties of the Beijing low income, low-income families; encountered Other special difficulties of the family.
(2) Individuals without dependents
Individuals who are temporarily unable to receive family support due to fire, traffic accidents, sudden major illnesses, or other special difficulties, leading to difficulties in basic living.
(3) Victims of emergencies
Because of natural disasters, accidents and calamities, public **** health, social security and other emergencies, the need to carry out emergency relocation and basic life assistance, as well as belonging to the scope of the emergency relief for diseases, in accordance with the relevant provisions.
Beijing big disease relief application location:
Qualified can be to the local township government (street office) to apply for temporary assistance, entrusted by the applicant, the village (residence) committee or other units, individuals can be on behalf of the application for temporary assistance.
The process of applying for assistance for major illnesses in Beijing:
(1) Apply for temporary assistance money
Apply to the township government (street office) where your household is located.
Holding a Beijing residence permit, you can apply to the township government (street office) where you live as an individual.
(2) Apply for relief services
Apply to relief management organizations and charity supermarkets in your area.
Apply for relief services from Beijing's relief management organizations at all levels.
(3) Referral services
For families or individuals in need of referral services, the local township government (street office) should assist them in applying to the relevant departments or units.
After the insured person enjoys the basic medical insurance treatment for urban residents in the current year, the part of the individual's out-of-pocket medical expenses (which have been deducted accordingly from the amount of medical aid from the civil affairs department) that exceeds the per capita disposable income of urban residents in the city in the previous year is included in the scope of coverage of the catastrophic illness insurance.
Included in the scope of reimbursement of major medical insurance out-of-pocket medical expenses include:
① urban residents of the basic medical insurance fund below the starting standard of medical expenses;
② urban residents of the basic medical insurance fund above the starting standard of medical expenses up to the maximum limit of payment of the proportion of medical expenses should be borne by the individual;
③ examination, treatment program The use of large-scale medical equipment and single cost of more than 200 yuan (including) should be borne by the individual first medical expenses;
④ basic medical insurance catalog of diagnostic and therapeutic items, medical services and facilities in the scope of Category B should be borne by the individual first medical expenses;
⑤ "Beijing Municipal Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drugs Catalog" of Category B drugs should be borne by the individual first medical expenses;
⑤ "Beijing Basic Medical Insurance, Work Injury Insurance and Maternity Insurance Drug List" should be borne by the individual
⑥ Medical expenses above the maximum payment limit of the basic medical insurance fund for urban residents that can be included in the scope of reimbursement with reference to the payment regulations of the basic medical insurance fund for urban residents, as well as the medical expenses in line with (3), (4) and (5).
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