Source:Zhoushan Daily-Zhoushan Net
Focusing on the requirements of fairer, more precise, and more beneficial to the people, our city fully implements municipal-level coordination of medical insurance. Not only the employee medical insurance, resident medical insurance, serious illness insurance fund implements the unified income and expenditure of the city, but also the insurance coverage, financing policy, guarantee benefits, Fund management, handling services, supervision and management policies are unified and improved. This is what the reporter learned from the Municipal Medical Security Bureau yesterday afternoon.
According to Lu Jinqi, Director of the Treatment and Service Management Division of the Municipal Medical Insurance Bureau, the medical insurance policies of the counties and districts in our city were slightly different. The medical insurance funds were deposited by the counties, collected by the counties, and used by the counties. Since 2012, the city has implemented a medical insurance fund adjustment system, and counties and districts have paid a portion of the adjustment funds to join the municipal medical insurance fund overall planning system. At present, as a pilot in the province, our city fully implements city-level overall planning, establishes a mechanism for sharing the responsibility of city and county (district) fund risks, and effectively improves mutual fund assistance and anti-risk capabilities. At the end of March this year, it was the first to achieve unified fund revenue and expenditure.
It is understood that the city will unify the insurance coverage, financing standards and treatment levels of the city’s basic medical insurance, critical illness insurance, medical assistance and other systems, and implement a unified medical insurance catalog, medical service prices, bidding and procurement payment method. Our city’s unified insurance coverage includes:employees who participate in medical insurance for employees of state agencies, enterprises, institutions, social organizations, individual industrial and commercial households with employees, etc., and Flexible employment personnel; resident medical insurance insured persons are residents of this city who have participated in employee medical insurance, students who are registered in our city’s schools outside the city, and hold residence permits within the validity period of this city, etc. Personnel; critical illness insurance participants are all persons participating in the basic medical insurance; medical assistance is targeted for extremely poor, subsistence allowances, low-level persons, and other persons with special difficulties specified by the people’s government at or above the county level.
Under the unified funding standard, the employee medical insurance premium is paid by the employer and the employee together, and the payment ratio shall not be lower than the provincial standard; the resident medical insurance premium is composed of the individual payment of the insured person and government subsidies. The per capita financing standard shall not be lower than 2.5%of the per capita disposable income of residents in the city in the previous year, and the ratio of individual payment to government subsidies shall not be lower than 1:2. Individuals with special poverty, subsistence allowances, low-side and second-level and above disabilities shall be fully borne by the finances. The critical illness insurance premium is paid jointly by the government (employing unit) and the individual. Establish a multi-channel critical illness insurance financing mechanism reasonably shared by the government (employing units) and individuals, and reasonably determine the annual financing standards for critical illness insurance based on the occurrence of major diseases. The medical assistance fee is fully arranged by the finance.
Our city will also unify and improve the multiple and compound medical insurance payment methods under the total budget management by disease group, bed day, and project. Fully implement the centralized procurement policy of drugs and medical consumables that are unified by the state, provinces, and cities, and the price is linked. The municipal medical insurance department will supervise each medical institution to complete the procurement tasks on time. Formulate and improve the city’s unified medical service price, and implement a unified medical insurance payment standard.
According to the introduction, the city will also realize the unification of designated medical institutions and mutual recognition among counties and districts through the integration of service management; promote the”handheld office” and”online office” to realize the”one-stop” medical insurance business management. City Office”. According to reports, the city-level coordination of medical insurance in our city will be implemented on a pilot basis from January 1 this year and will be basically mature by the end of the year.