Jinan Long-term Care Insurance Policy

After the municipal health insurance agency issues a notice of new fixed-point, the service organization that meets the conditions stipulated in the Administrative Measures may submit an application for assessment of the conditions of the fixed-point organization for long term care according to the requirements and provide the declared information. The municipal health insurance agency determines the long-term care fixed-point organization in accordance with eight steps, including issuing notices, accepting and verifying information, on-site verification, collective assessment, announcement of the list, policy and business training, installing the system and directory maintenance, and signing the service agreement.

Treatment conditions and service contents

Participants who have been or are expected to be bedridden for more than six months due to illness or disability, who are unable to take care of themselves, whose conditions are basically stable, and who have a score of ≤50 according to the "Daily Living Ability Assessment Scale" (Exhibit 1, hereinafter referred to as the "Assessment Scale"), and who are in compliance with the stipulated conditions, may apply for long-term medical care insurance treatment.

(1) Those who apply for specialized medical care (hereinafter referred to as specialized care) shall meet one of the following conditions:

1. terminal malignant tumors (malignant state);

2. long-term retention of tracheal cannula, biliary tract and other external drainage tubes, fistula tubes, deep venous catheters and other tubes (excluding nasogastric tubes and catheterization tubes) for the reason of medical conditions, which require regular treatment of traumatic surfaces;

3. Those who need to rely on medical equipment such as ventilators to maintain their vital signs for a long period of time;

4. Those who are suffering from various serious irreversible diseases and are paralyzed or paraplegic, and need to be hospitalized for a long period of time.

(2) Applicants for institutional medical care (hereinafter referred to as institutional care) and home medical care (hereinafter referred to as home care) shall meet one of the following conditions:

1. Those who meet the criteria for applying for specialized care;

2. Those who need to retain nasal feeding tubes and urinary catheters for a long period of time;

3. Those who have fractures that do not heal for a long period of time and have a combination of other chronic diseases;

4. Patients with the following chronic diseases:Parkinson's disease (severe), vegetative, severe rheumatoid arthritis in advanced stage (severe deformation of multiple joints) or other severe chronic bone and joint diseases affecting holding and walking.

Legal basis: "The General Office of the Ministry of Human Resources and Social Security on carrying out long-term care insurance system pilot guidance" Article 5 Scope of protection. Long-term care insurance system to long-term incapacity in the state of the insured people as the object of protection, focusing on solving the severe incapacity of the basic life care and basic life closely related to the medical care and other required expenses. Pilot areas can be based on the affordability of the fund to determine the focus of the protection of the population and the specific content of the protection, and gradually adjust the scope of protection and the level of protection with economic development.