The "universal medical insurance" in Shaanxi is an inclusive supplementary medical insurance supported by the government and connected with the basic medical insurance. It is an important part of the multi-level medical security system in Shaanxi Province. Strive to effectively solve the problem of medical treatment for the insured people in Shaanxi Province, improve the medical security level of the insured people in basic medical insurance, and provide temperature risk protection services for Shaanxi citizens.
So what are the characteristics of this supplementary medical insurance? What is the deductible? Who can insure it? How to participate in insurance? The reporter comprehensively sorted out the above problems.
Both internal and external expenses of medical insurance are guaranteed, with a maximum reimbursement of 4.5 million.
From the specific security point of view, Shaanxi's "national health" pays more attention to the three major security responsibilities. Not only the hospitalization expenses within the scope of basic medical insurance, but also the hospitalization expenses outside the scope of medical insurance, including the high reimbursement expenses of 36 special drugs.
Responsibility 1: Insurance premium for hospitalization (including outpatient special treatment) in the basic medical insurance catalogue. After the reimbursement of medical insurance, if the related expenses incurred in hospitalization in the designated medical institutions of medical insurance exceed the annual deductible of 6.5438+0.2 million yuan, they can be reimbursed according to the proportion of 80%, and the maximum annual compensation can be 6.5438+0.5 million yuan.
Responsibility 2: Insurance of hospitalization expenses outside the basic medical insurance catalogue. For medical treatment in medical institutions designated by medical insurance, the third liability * * * enjoys an annual deductible of 6.5438+0.8 million yuan, and the reimbursement rate is 60%, and the maximum annual compensation can be 6.5438+0.5 million yuan. It also includes popular proton and heavy ion cancer treatment technologies.
Responsibility 3: Domestic specific drug cost insurance, including 19 major diseases and 36 domestic specific high-priced drugs, including the current popular cancer therapy "CAR-T therapy". Responsibility 2 * * * enjoys an annual deductible of 6.5438+0.8 million yuan, with an reimbursement rate of 80%, and the highest annual deductible can be 6.5438+0.5 million yuan. There are also domestic special medicine direct compensation services, home delivery and other special medicine services. At the same time, for patients with previous diseases, the annual deductible of products will be increased to 20,000 yuan, and the reimbursement ratio will be reduced to 30%.