This is undoubtedly good news for us ordinary people.
However, due to insufficient understanding of the medical insurance policy, many people don't know that this money has gone up, but how to make up for it?
And the understanding of medical insurance is not comprehensive. Is it cost-effective for most people to pay medical insurance?
If you are not sick, there is still doubt whether this money was paid in vain, so today relevant experts answered questions about medical insurance. Let's have a look!
0 1
Financial subsidies for medical insurance for urban and rural residents have increased again.
In this year's government work report, it is specifically mentioned that the national subsidy standard for residents' medical insurance has risen again.
How to make up this money? What is the current state subsidy?
Wang Zongfan, Director of Medical Insurance Research Office of China Academy of Labor and Social Security:
At present, our medical insurance is divided into two types, one is employee medical insurance, and the other is urban and rural residents medical insurance. In his government work report, the Prime Minister said that the per capita financial subsidy for medical insurance for urban and rural residents increased by 30 yuan.
"The payment of medical insurance for urban and rural residents is actually composed of two parts, one is our financial subsidy, the other is the government's financial subsidy, and the other is the payment from individuals.
It is understood that the bottom line of our country's financial subsidy for residents' medical insurance last year was that each person should reach 580 yuan at least every year, and now it is 6 10 yuan.
Last year, the personal payment standard was in 320 yuan, but it has not been decided yet. According to the same amount in previous years, or a little more, I think I may go to 350 yuan this year. "
02
What does medical insurance include?
Everyone has been talking about medical insurance, but many people may not know exactly what medical insurance includes. What does medical insurance include?
Wang Zongfan, Director of Medical Insurance Research Office of China Academy of Labor and Social Security:
"Medical insurance is actually a multi-level medical security system. What I just said is the payment of "580+320", which is the so-called basic medical insurance for urban and rural residents. Of course, this is our most important and basic insurance, covering all people. All of us, including urban and rural residents, must participate in this insurance, which is basically covered by the whole people.
Besides, we also have a critical illness insurance, which covers all urban and rural residents.
There is also a level that the government is responsible for, called medical assistance, which is aimed at some people in need.
For example, if you can't afford medical insurance, your personal burden is particularly high.
For some people with special expenses, in addition to basic medical insurance and critical illness insurance, there is also a medical assistance that can be reimbursed. We call it the' triple guarantee' of the government. "
03
What is the proportion of medical insurance reimbursement?
What is the reimbursement rate after paying medical insurance?
Wang Zongfan, Director of Medical Insurance Research Office of China Academy of Labor and Social Security:
"According to last year's statistics, the average reimbursement rate of medical insurance for urban and rural residents in China is around 70%.
In fact, there has been a small increase every year in recent years, and our treatment level is still improving.
In addition, critical illness insurance is also enjoyed by everyone. As long as you enjoy basic medical insurance, you can also enjoy critical illness insurance.
There is a deductible line for critical illness insurance, that is, after the basic medical insurance is reported, your burden will reach about half of the annual average income, and your personal burden will be above this, and your out-of-pocket expenses can still be reported at 60% or even higher.
These two benefits can be superimposed, so we can say that on the basis of 70%, patients with severe illness can have one more layer, and the reimbursement ratio of critical illness insurance can be increased from 12% to 14%, that is, 70% to 80%. "
04
Is it cheaper to see a doctor now?
Let's look at an example first.
Peng Mengqiong, an 86-year-old man, is a villager in Zhuqing Village, Liu Jia Town, Xuzhou District, Yibin City, Sichuan Province. On February/0/4, 2004, he was accidentally injured at home, resulting in a fracture of the intertrochanteric bone of the right thigh and was admitted to hospital for treatment. After 16 days of hospitalization, the old man has reached the condition of discharge through surgery and medicine.
On March 2, the reporter followed Xie Minghong, the grandson of the old man, to go through the discharge formalities. How much did the old man spend in hospital this time?
According to the expense list, Peng Mengqiong was hospitalized 16 days, and the medical expenses totaled RMB, including three materials of hip prosthesis 17850 yuan. After passing the relevant preferential policies, the individual pays more than 7,000 yuan, and after other drugs and treatment expenses are reimbursed, the elderly are hospitalized this time, and the individual pays RMB.
Xie Minghong, a villager from Zhu Qing Village, Liu Jia Town, Xuzhou District, Yibin City, Sichuan Province:
In fact, the cost is generally acceptable, but the cost of this self-funded prosthesis is a bit expensive.
Liu Fang, a staff member of Medical Insurance Bureau of Xuzhou District, Yibin City, Sichuan Province:
At present, artificial joints in our area have not been included in the scope of centralized mining. The implementation time of centralized procurement of artificial joints is decided by the alliance area, which is expected to be in March-April this year. The prices of all materials included in centralized procurement have dropped significantly. For example, the price of coronary balloons has gone from about 3,350 yuan before centralized procurement to 350 yuan after centralized procurement.
Yongzheng, Vice President of the Third People's Hospital of Xuzhou District, Yibin City, Sichuan Province:
Especially for some patients with long-term chronic diseases, the highest price reduction of drugs has reached more than 95%. For example, an antihypertensive drug commonly used in our hospital is amlodipine besylate. In the past, a box cost more than 20 yuan, but now it only costs RMB, which is obviously different from before.
05
I'm not sick. Is medical insurance for nothing?
Some netizens may be young and not very sick, and feel that it is nothing to pay so many premiums every year. What do you think of this problem?
Wang Zongfan, Director of Medical Insurance Research Office of China Academy of Labor and Social Security:
"We put medical insurance for urban and rural residents in a larger concept. We call it a kind of social insurance. This is the model of our system, called social insurance. "
What are the characteristics of social insurance?
First, it's mandatory. Everyone has to pay.
Second, you must fulfill your payment obligations in order to enjoy it. In our country, for residents' medical insurance, in fact, the government supports individual payment to a large extent, and we don't pay ourselves.
Almost two-thirds of our money comes from financial subsidies, and individuals only contribute a part. In fact, about one-third of the final medical expenses are reimbursed by individuals, and two-thirds come from the financial subsidies given to you.
Although you paid it this year, you may not be ill and didn't spend any money. You will give this money to others to help each other.
When you are sick, when others are not sick, he pays to help you. This is what we call social insurance. A very important principle is mutual assistance. The reason is very simple, that is, I am for everyone and everyone is for me.
Everyone should have a long-term perspective on this payment problem.
The medical insurance account is a long-term large account, which is used for crisis rescue and emergency management. You can't just look at the present, just look at yourself. I believe that with the further deepening of medical insurance reform, the problem of difficult and expensive medical treatment will be improved year by year.