1, the proportion of overall subsidies for township and village clinics increased to 65% and 75% respectively;
2, a medical institution hospitalization expenses below 400 yuan, no deductible;
3, secondary medical institutions to increase the proportion of subsidies to 75% to 80%;
4, the proportion of tertiary medical institutions subsidies increased to 55% to 60%;
5, the proportion of provincial tertiary medical institutions subsidies increased to fifty-five percent;
6. Eight kinds of serious diseases such as congenital heart disease in children, 70% of the quota of subsidized diseases of the new rural cooperative medical system, lung cancer and other 12 kinds of serious diseases, and the quota of subsidized diseases of the new rural cooperative medical system will strive to reach 70%.
Medical insurance reimbursement scope:
1. The insurance liability of hospitalization medical expenses within the scope of medical insurance, and the expenses that are still borne by individuals after some expenses in the medical insurance catalogue are reimbursed by basic medical insurance, serious illness insurance and medical assistance. , shall bear the liability for compensation within the agreed scope of insurance liability. 1 10,000 insured amount,10.5 million free of compensation, the reimbursement rate is 80%, and the reimbursement rate for continuous participation is increased to 85%;
2. The insurance liability of hospitalization medical expenses outside medical insurance coverage, as well as the part that is still borne by individuals after the expenses outside the medical insurance catalogue are reimbursed by basic medical insurance, serious illness insurance and medical assistance, shall be liable for compensation within the agreed scope of insurance liability. 1 10,000 insured amount,1.8,000 free of compensation, the reimbursement rate is 60%, and the reimbursement rate for continuous participation is increased to 65%;
3, outpatient specific high drug costs insurance liability, in designated hospitals, designated pharmacies, drug costs borne by individuals, within the agreed scope of insurance liability, bear the liability for compensation. 700,000 insured amount, 26 kinds of drugs, and the insurance liability of the outpatient drugs/inpatient medical insurance expenses for rare diseases is * * * 20,000 yuan, and the compensation ratio is 80%;
4. Designate the insurance liability of outpatient drugs for rare diseases/hospitalization medical insurance expenses, and pay part of the drug expenses paid by individuals in designated hospitals and pharmacies within the agreed scope of insurance liability. The insured amount is 300,000 yuan, 12 kinds of drugs, and the insurance liability of outpatient specific high drug expenses is 20,000 yuan, and the reimbursement ratio is 70%.
To sum up, basic medical insurance (including basic medical insurance for urban workers and basic medical insurance for urban and rural residents) is closely related to inclusive prices. Focus on ensuring the high medical expenses caused by major diseases and accidental injuries, and provide more adequate protection for major diseases. Compared with general commercial insurance, there are no restrictions on the age and occupation of the insured, and the health conditions are more tolerant. At the same time, the treatment cost of 20 kinds of high-priced specific drugs and 10 kinds of designated rare diseases drugs outside the medical insurance catalogue has been expanded.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.