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Chengdu Municipal People's Government Decree
No. l54
The Measures for Basic Medical Insurance for Chengdu Municipal Workers and Urban Employees have been discussed and adopted at the 22nd executive meeting of the municipal government on November 3, 2008, and are hereby promulgated to come into force as of January 1, 2009.
Mayor Ge Honglin
November 18, 2008
Chengdu Municipal Bureau of Labor and Social Security on the implementation of municipal government orders No. 154 and No. 155 on issues related to the reply letter
Chengdu Labor and Social Security Letter [2009] No. 40
Chengdu Municipal Bureau of Medical Insurance:
Your Bureau of Medical Insurance:
Your Bureau of Medical Insurance:
"On the implementation of municipal government orders Nos. 154, 155 of the relevant issues of the Please indicate" (Chengdu Medical Report [2009] No. 9) received. The answers to the questions raised by you, after study, are as follows:
Part I Basic Medical Insurance for Urban Workers in Chengdu City
I. Individual insured persons referred to in Article 6 of the Measures include individual industrial and commercial households without employees, freelancers, flexibly-employed persons, and other persons participating in the basic medical insurance for urban workers in the status of an individual in accordance with the documents of the provincial and municipal governments.
Second, "Measures" Article 10, paragraph 6, "within 3 days before admission" refers to the first 3 days of hospitalization procedures. For example: Li was admitted to the hospital on the 5th, during the period from the 2nd to the 5th, the outpatient positive special examination fees incurred in the hospital where he was admitted (based on the time recorded in the invoice) were included in the reimbursement of the integrated fund.
Third, the "Measures" Article 10, paragraph 6, "special examination" refers to the basic medical insurance payment scope of X-ray imaging, magnetic *** vibration scanning (MRI), X-ray computerized tomography (CT), color Doppler ultrasonography, gamma photography, single photon emission computed tomography (SPECT), leukemia residual foci (SPECT), and other special examinations, which are not covered by the basic medical insurance. The company's diagnostic and therapeutic equipment includes the following tests: leukemia residual lesion detection, tumor-associated antigen determination, dynamic electrocardiogram, dynamic electroencephalogram, fiberoptic bronchoscopy, gastroscopy, enteroscopy, histopathological examination and diagnosis, and anti-pollution sampling and brush inspection via fiberscope.
Four, "Measures" Article 13, paragraph 2, "the implementation of a single price of more than 1,000 yuan of surgical fees," only refers to the surgical project itself, does not include anesthesia, materials, nursing, monitoring and other related costs.
Fifth, the "Measures" Article 16, paragraph 1, continuous uninterrupted payment of contributions, refers to the January 2009, has been in the unit and the employer's individual industrial and commercial enterprises to participate in the city's basic medical insurance, from January 1, 2009 onwards to pay the basic medical insurance premiums shall not be interrupted. If there is any interruption, it will be dealt with according to the provisions of Article 18 of the Measures.
Sixth, "Measures" Article 16, paragraph 2, expressed in the "uninterrupted participation in the basic medical insurance for urban workers in an individual capacity" means that after the termination of the labor relationship with the original unit, should be in an individual capacity within four months of the continuation of medical insurance. Continuous and uninterrupted payment of contributions means that those who left their units due to bankruptcy, restructuring or institutional reform before January 1, 2001 shall pay basic medical insurance premiums uninterruptedly from January 1, 2001 until they reach the statutory retirement age; those who left their units due to bankruptcy, restructuring or institutional reform after January 1, 2001 shall pay basic medical insurance premiums uninterruptedly from the date of termination of the labor relationship with their units to the date they reach the statutory retirement age. shall pay the basic medical insurance premiums uninterruptedly, and shall make up for any interruption.
Seven, after January 1, 2009, Chengdu City, administrative areas due to land expropriation and non-agricultural population registration, the expropriation department of the one-time payment of the basic medical insurance premiums for their years of experience, the time of payment from the expropriation of land compensation and resettlement program approval date forward calculation. If the calculated time is before January 2009, it is regarded as enrollment before the implementation of the Measures, and vice versa, it is enrollment after the implementation of the Measures. Example: Zhang's land was legally expropriated in 2016 and registered as a non-agricultural population, and the land expropriation department paid the basic medical insurance premiums for him for 10 years at one time, i.e., 2016-10=2006, and Zhang belonged to the insurance before the implementation of these Measures.
Eight, in order to ensure that the city's retirees outpatient medical treatment is not reduced, the study decided that the implementation of the provisions of Article VIII of the Rules cease to be implemented. From January 1, 2009, the city's retirees health insurance personal account transfer, in strict accordance with the provisions of the municipal government Order No. 154 transfer. Institutions and agencies to declare the individual account of the retiree's gold, you need to provide the approval form of retiree's pension with the signature of the Personnel Bureau, and if the pension relationship is in the province, you need to provide the certificate of retiree's pension payment which is confirmed by the provincial social security office.
Nine, psychiatric diseases for the first time to apply for outpatient special diseases, you need to provide the city's basic medical insurance designated psychiatric hospitals or general hospitals above the second grade A psychiatric diagnosis issued by the diagnosis of the disease.
X. Participants who have applied for medical treatment in other places can be reimbursed for the hospitalization medical fees incurred in the city in accordance with the regulations in the integrated fund.
Xi, military dependents of medical insurance relations in accordance with the provisions of Article 19 of the Measures.
The second part of the basic medical insurance for urban and rural residents in Chengdu City
I. The medical expenses incurred by urban and rural residents who are out of the city for work-related injuries shall be carried out in accordance with the relevant provisions of the Regulations on Work-Related Injury Insurance. Medical expenses incurred for infertility treatment are not covered by basic medical insurance and will not be paid by the basic medical insurance fund for urban and rural residents.
Two, before January 1, 2009 has participated in the city's supplementary medical insurance and the insurance relationship has not been interrupted urban and rural residents, can continue to participate in the supplementary medical insurance in accordance with the provisions of the supplemental medical insurance; after January 1, 2009 has not participated in the city's urban and rural residents of the supplemental medical insurance, suspension of the purchase of supplemental medical insurance.
Third, the Chengdu Municipal Labor Security Bureau approved the inclusion of basic medical insurance reimbursement of hospital preparations, applicable to the hospital's medical insurance business scope of all service recipients.
Fourth, for those who participate in the basic medical insurance for urban and rural residents, the hospitalization medical fees for birth complications during childbirth are reimbursed in the fund in accordance with the provisions of the basic medical insurance for urban and rural residents.
V. Urban residents insured under Chengdu Municipal People's Government Decree No. 134 may be transferred to basic medical insurance for urban workers, with the number of years of contributions calculated jointly; they may also be transferred to basic medical insurance for urban and rural residents. If the effective period of treatment is after January 1, 2009, the effective period will be extended to December 31, 2009. The reimbursement treatment is in accordance with the Interim Measures for Basic Medical Insurance for Urban and Rural Residents of Chengdu City, Article 13, Grade 3, to enjoy the medical insurance treatment, but not the outpatient subsidies.
Fifth, non-city residents to participate in the city's urban and rural residents of the basic medical insurance in schools, primary and secondary school students, winter and summer vacations to return to their hometowns in the local basic medical insurance designated medical institutions of the hospitalization medical expenses incurred in the urban and rural residents of the basic medical insurance fund for reimbursement.
Seven, newborn babies can participate in the city's urban and rural residents of the basic medical insurance, regardless of the full-month limit.
April 15, 2009