Implementation Measures for Basic Medical Insurance for Employees in Yichang City, Implementation Measures for Basic Medical Insurance for Urban and Rural Residents in Yichang City, Implementation Measures for Large Medical Expenses Subsidy for Employees in Yichang City, and Notice on Further Adjusting and Improving the Outpatient Chronic Disease Policy of Basic Medical Insurance in Yichang CityIt will come into force on January 1, 2024.
Now the relevant medical insurance policy.
The main changes in the content.
Interpret it. 
1.What are the changes in the payment of employee medical premiums by flexibly employed persons?
Answer: The payment base for flexible employment personnel to participate in the employee medical insurance shall be from the monthly standard of the city's social insurance payment base70% to 60%.
What are the changes in the payment period for the insured persons who participated in the pension insurance before the implementation of the Yichang employee medical insurance system?
A: The number of years of paymentChanged from "actual continuous payment" to "cumulative actual payment".When reaching the statutory retirement age and going through the medical insurance liquidation procedures, the "cumulative actual payment" period in Yichang CityNot less than 15 years,The requirement for the number of years to pay has become more lenient than before. What are the conditions to enjoy medical insurance retirement benefits, and what is the difference between them and in-service employees?
Answer: Insured persons who have reached the statutory retirement age and the number of years of medical insurance payment for employees have reached the standards stipulated by the city, and they do not need to pay after retirement, and enjoy medical insurance retirement benefits according to the regulationsThe level of general outpatient treatment of insured persons enjoying medical insurance retirement benefits is higher than that of in-service employees, and the level of other medical insurance benefits is the same as that of in-service employees.
What are the changes in the policy of liquidating medical premiums when the insured person reaches the statutory retirement age and does not reach the prescribed payment period?
Answer: When the insured person reaches the statutory retirement age, he has not reached the prescribed payment periodIt can be paid in a lump sum or on a yearly basis (monthly).ContributionsMedical premiums up to the specified number of years;The one-time single payment or annual (month-by-month) payment base shall be from the monthly standard of the city's social insurance payment base100% to 60%.Contribution rates from:10% to 8%. What are the changes in the hospitalization treatment standards of basic medical insurance for employees?
A:The first is to lower the threshold for hospitalization. The threshold for hospitalization in first-level medical institutions has been reduced from 300 yuan to 200 yuanThe threshold for hospitalization in secondary medical institutions has been reduced from 600 yuan to 500 yuan. The second is,Increase the reimbursement rate for hospitalization. The reimbursement rate of Class A inpatient expenses in first-level medical institutions has been increased from 90% to 92%, and the reimbursement rate of Class B expenses has been increased from 70% to 874%；The reimbursement rate of Category A expenses for hospitalization in secondary medical institutions has been increased from 88% to 90%, and the reimbursement ratio for Category B expenses has been increased from 70% to 855%；*The reimbursement rate for hospitalization expenses in medical institutions has been increased from 85% to 88%, and the reimbursement rate for category B expenses has been increased from 70% to 836%。The third is,Increase the annual payment limit of the overall planFrom 120,000 to 150,000. What are the changes in the treatment time after the flexible employment personnel participate in the insurance and pay the premium?
Answer: The waiting period for the first insurance treatment of flexible employeesShortened from 6 months to 3 months. Have participated in basic medical insurance for more than 2 consecutive years (including 2 years) and interrupted the payment timeNot more than 3 monthsof flexible employees, after paying medical insurance fees according to regulations, can retroactively enjoy the benefits of the interruption period;In other cases of interruption of payment, the medical insurance premium cannot be paid back, and the payment is received from the account after the re-enrollment paymentMonth 4Start enjoying the treatment. What are the changes in the policy of remote medical treatment?
A:CanceledFiling and medical treatment in other places in the province10% out-of-pocket upfrontWhen insured employees seek medical treatment in other placesConsistent with the reimbursement policy for local medical treatment in Yichang City;Inter-provincial long-term residence, referral, emergency rescue personnelOut-of-town medical treatment is consistent with the local reimbursement policy. 
Which special groups can participate in the medical insurance for urban and rural residents during the non-centralized payment period?
Answer: The following categories of personnel can participate in the medical insurance for urban and rural residents during the non-centralized payment period:It has been more than 2 consecutive years (including 2 years).Persons who participate in basic medical insurance, and whose payment is interrupted due to changes in their personal status such as employment and switching between employee medical insurance and resident medical insurance, newborns, termination of the implementation of other medical security systems (demobilized soldiers, former publicly-funded medical personnel, persons released from prison, etc.), urban and rural persons in extreme poverty, orphans, de facto unsupported children, disabled persons who have lost the ability to work, patients with severe mental disorders, couples from extremely poor families in special family planning families and their disabled children, urban and rural minimum living security recipients, Elderly people over the age of 60 and minors in urban and rural subsistence allowance marginal family members, people who have returned to poverty and caused poverty, rural people who are vulnerable to poverty and poverty (including those who are unstable in poverty alleviation, marginal and vulnerable to poverty, and those who have sudden and serious difficulties) who are included in the monitoring scope, and those who have been stably lifted out of poverty during the transition period. What are the changes in the overall treatment of general outpatient clinics of medical insurance for urban and rural residents?
A:Abolish the 50 yuan general outpatient co-ordinated minimum payment line and the 20 yuan daily payment limitThe cost of prenatal examination will be included in the scope of general outpatient insurance for residents. What are the changes in the standard of hospitalization treatment of basic medical insurance for residents?
A:The first is to increase the reimbursement ratio for hospitalization of Class B expenses. The reimbursement rate for hospitalization of Class B expenses in first-level medical institutions has been increased from 80% to 81%;The reimbursement rate for hospitalization for Class B expenses in secondary medical institutions has been increased from 65% to 675%；*The reimbursement rate for hospitalization for Class B expenses in medical institutions has been increased from 50% to 54%. The second is to increase the annual payment limit of the overall planFrom 120,000 to 150,000.
What are the changes in the policy of remote medical treatment?
A:CanceledFiling and medical treatment in other places in the provinceThe 10% out-of-pocket ruleWhen an insured resident seeks medical treatment in a different placeConsistent with the reimbursement policy for local medical treatment in Yichang City;Inter-provincial long-term residence, referral, emergency rescue personnelOut-of-town medical treatment is consistent with the local reimbursement policy.
What are the changes to the reimbursement policy for accidental injuries and hospitalization for hospital births?
A:CancellationAccidental injury is the maximum payout per hospitalizationThe limit is 5,000 yuan and the maximum payment limit for hospital delivery is 1200 yuan and other provisions,Eligible expenses will be reimbursed with reference to the general illness hospitalization policy. 
What is the Employee Subsidy for Large Medical Expenses?Why the new policy?
Answer: The subsidy for large medical expenses for employees was originally known as large medical insurance for employees, which is a policy to further protect the high medical expenses of insured employees who meet the regulations. In accordance with the requirements of the national and provincial medical security treatment list system, in order to further standardize the medical security policy framework, the city's former employees' large-amount medical insurance and the former employees' secondary subsidy policy will be integrated into the large-amount subsidy system for employees. What are the changes in the payment standards and funding channels of the new policy?
Answer: The payment standard for large medical expenses subsidy for employees in Yichang City is currently 12 yuan per person per monthAdjusted to a payment method based on the payment base multiplied by the payment rateThe payment base is the social insurance payment base standard formulated by the provincial level every year, and the payment rate is 02%；The financing channels remain unchanged, and the basic medical insurance for employees is levied on a monthly basis, and the in-service employees of the unit are paid by the employer, and the flexible employment personnel are paid by the individual, and the retirees do not pay.
What are the changes in the treatment of the new policy?
Answer: The new policy follows the starting standard and reimbursement ratio of the original employee's large-amount insurance and the former employee's second subsidy, and is based on the superposition of the annual payment limit of 350,000 yuan for the original employee's large-amount insurance and the annual payment limit of 80,000 yuan for the second subsidy for the original employeeThe annual payment limit of large subsidies for employees will be increased to 450,000 yuan. 
What are the changes in the types of outpatient chronic diseases in Yichang?
Answer: Yichang City's outpatient chronic disease policy implements the unified regulations of the province for diseases and access standards, which are divided into:11 kinds of outpatient special diseases and 27 kinds of outpatient chronic diseases, compared with the city's original outpatient chronic disease policy, the new Wilson's disease, epilepsy, Alzheimer's disease, thyroid dysfunction, heart valve replacement, bypass, in vivo stenting after postoperative five diseases, malignant tumor outpatient special and outpatient conservativeMerge into one disease,Termination of Sjögren's syndrome, bronchiectasis, pulmonary fibrosis of the new crown pneumonia, etcFor the three diseases, there will be no new personnel for the diseases that have been terminated, and the insured persons who have already enjoyed the treatment of the disease will continue to retain their qualifications and enjoy the treatment according to the original standards. The specific diseases are:
There are 11 kinds of outpatient special diseasesIncluding malignant tumor outpatient clinic**, chronic renal failure dialysis, organ transplant anti-rejection**, severe psychosis, hemophilia, phenylketonuria, thalassemia, tuberculosis, autism, growth hormone deficiency, Wilson's disease and other diseases;
There are 27 outpatient chronic diseasesIncluding chronic renal failure, systemic lupus erythematosus, diabetes mellitus, aplastic anemia, hypertension, viral hepatitis, liver cirrhosis, Parkinson's disease, Parkinson's disease, rheumatoid arthritis, coronary heart disease, myasthenia gravis, ankylosing spondylitis, sequelae of cerebrovascular disease, cor pulmonale, systemic sclerosis, chronic osteomyelitis, rheumatic heart disease, bronchial asthma, epilepsy, cerebral palsy, chronic obstructive pulmonary disease, idiopathic pulmonary interstitial fibrosis, Alzheimer's disease, thyroid dysfunction, Chronic heart failure, as well as heart valve replacement, bypass, internal stent implantation and other diseases.
What are the changes in the treatment level of outpatient chronic diseases in Yichang City?
Answer: The relevant expression has changed, the "monthly limit standard" in the original policy refers to the medical expense limit within the policy, not the final reimbursement amount of medical insurance co-ordination, and the "annual payment limit" in the new policy refers toMedical insurance co-ordination** can be reimbursed.
In addition, the level of treatment has been greatly improved, and the annual payment limit is compared with the previous policyAveragean increase of 53 percentage points, Resident Medical InsuranceAn average increase of 44 percentage points, the reimbursement ratio is compared with the previous policy, employee medical insurancean increase of 5 to 15 percentage points, Resident Medical InsuranceThis is an increase of 10 to 20 percentage points.
*丨Yichang release, Yichang medical insurance.
Editor丨Xiaolang Editor丨Zhai Tingting**must be indicated**.