To create a “15-minute medical insurance service circle”, Taibai Lake New District promotes the high-quality development of medical insurance

Reporter Deng Chao Correspondent Luo Qing

On November 24, Taibai Lake New District held a series of special press conferences on “Promoting People’s Livelihood and Well-being and Drawing Heart-warming Answers”. Adopt a combination of online and offline methods to introduce the development of medical security in Taibai Lake New District this year. Taibai Lake New District has always adhered to the development concept centered on people’s health, attached great importance to medical security, continuously increased financial investment, improved a fair and moderate medical security treatment mechanism, strengthened the triple security functions of basic medical insurance, serious illness insurance and medical assistance, and promoted High-quality development of medical security.

Increase the financial subsidy standard for residents’ medical insurance. Residents’ medical insurance participation costs are jointly borne by individuals and finance. In 2022, individual residents will pay 320 yuan, and financial subsidies will increase from 380 yuan/person in 2015 to 610 yuan/person. “. In 2022, there will be 91,700 insured persons in Taibai Lake New District, and the financial subsidy expenditure will be 16.7811 million yuan; Elderly people over the age of one year, and parents of single-daughter households with two girls in rural areas) paid 4.4624 million yuan for the personal payment of resident medical insurance. From January to October this year, a total of 10,930 insured residents in Taibai Lake New District enjoyed hospital treatment and paid a total of 51.2678 million yuan in medical insurance funds; a total of 28,552 outpatient chronic diseases enjoyed treatment and paid a total of 8.6348 million yuan in medical insurance funds; a total of 23,869 outpatient visits enjoyed treatment , a total of 840,400 yuan was paid to the medical insurance fund; a total of 523 people in needy families were hospitalized, and a total of 955,200 yuan was paid for assistance; a total of 2,845 outpatient visits were paid, and a total of 287,900 yuan was paid for assistance.

Improve the standard of medical insurance treatment . Increase the reimbursement ratio of residents’ medical insurance for hospitalization. For inpatient medical expenses incurred by insured residents in primary, secondary, and tertiary medical institutions, the proportion of medical insurance fund payment increased by 5%, from 80%, 70%, and 55% to 85%, 75%, and 60% respectively. Reduce the minimum payment standard for residents’ medical insurance for hospitalization. For insured residents who are hospitalized in first-, second-, and third-tier medical institutions, the basic medical insurance fund payment thresholds are reduced from 200 yuan, 500 yuan, and 1,000 yuan to 100 yuan, 400 yuan, and 800 yuan, respectively. The maximum payment limit of residents’ critical illness insurance is increased by 100,000 yuan. The proportion of residents’ critical illness insurance reimbursement has increased by 5%-10%, and the maximum payment limit has been raised from 300,000 yuan to 400,000 yuan. The maximum payment limit for the use of specific drugs has been increased by 200,000 yuan. The reimbursement rate for insured residents using prescribed specific medicines has been increased from 60% to 80%, and the maximum payment limit has been increased from 200,000 yuan to 400,000 yuan. Increase the maximum payment limit of employee medical insurance. The maximum payment limit of employee medical insurance was increased from 1.25 million yuan to 1.45 million yuan, of which the maximum payment limit of basic medical insurance was increased from 100,000 yuan to 150,000 yuan, and the subsidy for large medical expenses for employees was increased from 350,000 yuan to 500,000 yuan.

Improve the level of medical insurance handling services. Create a “15-minute medical insurance service circle”. A service circle based on the medical insurance office hall and supplemented by township (street) medical insurance service stations and designated medical institution medical insurance service stations has been formed in the whole region, so that the data will run more and the masses will run less errands. At present, medical insurance service stations have been established in 2 township (street) service centers and 3 hospitals to open up the last mile, so as to facilitate the provision of medical insurance handling services for residents.

Comprehensively implement the “one message” working mechanism. Send medical insurance business results and medical insurance knowledge policies to insured persons free of charge through the Shandong Provincial Medical Insurance SMS Service Platform, providing more intimate, warmer, and more convenient medical insurance services for insured people.

It is more convenient to seek medical records in different places. Cancellation of “temporary going out for medical treatment personnel” cross-city medical records within the province, inpatient and outpatient medical expenses incurred by insured people who seek medical treatment in different places within the province can be directly reimbursed online; medical treatment at designated medical institutions outside the province can be made through the medical insurance service hall, telephone, The National Medical Insurance Service Platform App and the WeChat Mini Program of “Jining Medical Insurance” have completed the filing of medical treatment in different places, and directly realized online settlement.