The payment of more than 102,000 people, the amount of compensation exceeds 357 million yuan, "Jiangsu Medical Huibao No. 1" benefits the people and the people

On September 8th, the Jiangsu Provincial Medical Security Bureau held the "Jiangsu Medical Hui Insurance No. 1" news ventilation meeting and promotion meeting. All services such as insurance, fast claims, etc., promote the construction of a multi -level medical security system, and meet the needs of the masses to diversify high -quality medical security.

The number of insureds has reached 3.221 million

The total amount of compensation exceeds 357 million yuan

Zhou Ying, Secretary of the Party Group and Director of the Jiangsu Medical Security Bureau, introduced that "Jiangsu Medical Hui Insurance No. 1" and the basic medical insurance effectively connected, facing all the insured persons in our province to create the inclusiveness of the masses "afford and buy" Commercial supplementary medical insurance, only 158 yuan per year. Since its launch in December last year, the "Jiangsu Medical Huibao No. 1" insured channel has continued to open. By August 31, the number of insureds has reached 3.221 million, the average age of the insured group is 51.6 years old, the oldest is 108 years old, the youngest is the youngest, the youngest is the youngest. Only 28 days were born. Among them, under the age of 50 accounted for 37%, 50 to 70 years old accounted for 49.3%, 70 years old accounted for 13.7%, and 89,000 elderly people over 80 years of age reached 89,000.

The reporter learned that "Jiangsu Medical Hui Insurance No. 1" achieved fast claims through simplifying claims procedures and sharing medical insurance big data. After the medical insurance settlement was discharged from the medical insurance, the operating service platform of "Jiangsu Medical Hui Insurance No. 1" only needed to fill in personal information Generally, there is no need to upload hospital medical documents to achieve the acceptance review on the day. On average, the settlement of 3.8 working days can be settled. At present, more than 80%of them have made claims through the "fast compensation" method, which greatly simplifies the application procedures for claims, compressed the claims time, reduced the burden on the people's pads and running legs, and provided the insured person with a good claim service experience. As of August 31, the number of "Jiangsu Medical Huibu No. 1" reached 35,000, the number of compensation was 102,000, and the total amount of compensation reached 357 million yuan, which has reached 70%of the premium income.

Provide multiple guarantees

Personal burden is reduced by 27.7%

"Jiangsu Medical Hui Insurance No. 1" provides multiple guarantees: responsibility first to ensure the part of the individual within the scope of basic medical insurance, effectively connect the "dual -channel" drug treatment of hospitalization, Mente, and state negotiation; Outside parts, focus on self -funded drugs and high -value medical consumables; the third responsibility is to ensure the re -guarantee part of the major diseases and re -guarantee high medical expenses. As of August 31, the number of claims for one claim was 34,000, and the amount of claims accounted for 75.9%of the total amount of claims; the number of liabilities was 4,227, and the claims amount accounted for 19.7%of the total amount of claims. The total is 4.3%.

On the basis of the main use of the responsibility of guarantee within the scope of basic medical insurance, "Jiangsu Medical Hui Insurance No. 1" has effectively supplemented the cost of self -funding and high medical expenses outside the scope of basic medical insurance, and realized the burden of medical expenses. In the case of 102,000 actual claims, after the "Jiangsu Medical Huibu No. 1" supplementary compensation, the average compensation ratio increased an average of 11 percentage points, and the average personal burden was reduced by 27.7%. The implementation of "Jiangsu Medical Huibao No. 1" has achieved the expected results, and the effect of benefiting the people and the people is obvious.

Zhou Ying introduced that from the perspective of the number of insured persons, guarantee responsibilities, fast compensation services, and the response of the masses, "Jiangsu Medical Hui Insurance No. 1" belongs to the forefront of the country, and the provincial commercial supplementary medical insurance that is closely connected with basic medical insurance is closely connected with basic medical insurance. Well -welcomed by the masses, they have achieved good social response. At present, the Provincial Medical Insurance Bureau and 11 Sports Insurance Company are studying the optimization and adjustment of the "Jiangsu Medical Hui Insurance No. 1" 2023 issuance plan, and continuously further promoted the people's livelihood practical affairs to achieve greater results.

Jiangnan Times reporter Sun Haiyan

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