[Recommended reading] Standard adjustment!Reason for urban and rural residents' serious illness insurance

A few days ago

Jilin Provincial Medical Security Bureau released

About 2022 urban and rural residents

Notice of major illness insurance work

The full text is as follows

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About 2022 urban and rural residents

Notice of major illness insurance work

Jiyi Medical Liana [2022] No. 13

Municipal (state) medical security bureaus, financial bureaus, Changbai Mountain Management Committee Medical Security Bureau, Finance Bureau, Meihekou Municipal Medical Security Bureau, Finance Bureau:

In order to further improve the system of urban and rural residents in our province (hereinafter referred to as the "Disease Insurance") system and promote the healthy and sustainable development of the system, in accordance Number) and "Opinions of the General Office of the Jilin Provincial People's Government on Further improving the Insurance System of Urban and Rural Residents' Disease Insurance System" (Ji Zhengjiefa [2016] No. 57, hereinafter referred to as "No. 57") and other documents. The relevant matters related to the work of major illness insurance are as follows.

1. Establish a provincial -level overall management mechanism for major illness insurance

With the implementation of the provincial unified collection of major illness insurance funds as the starting point, the basic medical insurance has been promoted to gradually achieve provincial overall planning. Establish a provincial -level overall management mechanism for major illness insurance, clarify the responsibilities of medical insurance, finance and other departments at all levels, and promote the sustainable development of the major illness insurance system. The specific measures for provincial -level overalls of major disease insurance are formulated by the provincial medical security department, together with the provincial finance and the CBRC.

2. Adjust the per capita fundraising standard for insurance and insurance

According to the operation of the province's major illness insurance system and combined with the level of economic and social development in our province, the per capita fundraising standards per capita of major illness insurance insurance in our province in 2022 to 90 yuan per person per year.

3. Adjust the Standards for Payment of Critical Condition Insurance

Adjust the starting standards of residents in our province to 12,000 yuan, of which: urban and rural insights, urban and rural subsistence allowance objects, poor people who return to poverty and poverty alleviation (hereinafter referred to as "difficult people"), the major illness insurance starting standard is adjusted to 6,000 yuan.

When the insured person is hospitalized (including special diseases from outpatient clinics), the personal payment part of the individual within the policy scope of the urban and rural residents' medical insurance fund (including the personal sharing ratio of the medical insurance regulations of urban and rural residents, the starting standard, and the class B individual in the medical insurance directory first enable themselves first self -presence. Payment part) Incident in the statistical caliber of the major illness insurance, the standard part of the super medical insurance payment standard is not included in the statistical caliber of the major illness insurance starting line. The starting payment line is calculated by the cumulative natural year.

Fourth, strengthen work connection

The adjustment standards for the adjustment of the major illness insurance for residents will be implemented from July 1, 2022. If the medical expenses incurred by the insured persons have reached the original payment standard, they will continue to be implemented in accordance with the original standard. The adjustment standard for the adjustment of the critical illness insurance after the adjustment is implemented from January 1, 2023.

Financial departments and medical insurance agencies at all levels should do a good job of raising the funds of major illness insurance in 2022, and the medical insurance department must make a good adjustment of the medical insurance information system. In response to this year's epidemic prevention and control of information system adjustments, people with major illness insurance on the right to pay the starting standard progress problem, the system adjustment period will still implement the original difficulty of the critical illness insurance starting standard to ensure the smooth connection of treatment.

Jilin Provincial Medical Security Bureau

Jilin Provincial Department of Finance

June 29, 2022

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