The three departments jointly released that there will be a major adjustment to medical insurance in

Mondo Social Updated on 2024-01-24

Recently, the National Health Commission, the Ministry of Human Resources and Social Security, and the Ministry of Finance jointly issued a major adjustment plan for medical insurance in 2023. This news has aroused widespread attention and expectations. The new policy will bring three good news, covering all aspects of medical security, which directly affect everyone's rights and well-being.

The National Health Insurance Administration, together with the Ministry of Finance and the State Administration of Taxation, issued a notice on the basic medical security for urban and rural residents in 2023, involving major adjustments to medical insurance. There are three pieces of good news that are relevant to each of our social security benefits. It is advisable to convey this important message to family and friends to let them know.

There is good news in the latest health insurance adjustment, that is, the standard of medical insurance protection has been raised again. This year, the self-paid part of the residents' medical insurance payment standard has reached 380 yuan, and the part of the national overall security has also increased by 30 yuan, reaching 640 yuan.

The total sum of the two parts is 1020 yuan. The level of medical insurance security has been improving every year, from the per capita payment standard of only 10 yuan when the system was established in 2003, and now it has exceeded 1,000 yuan, and the level of medical security for residents has been greatly improved.

The out-of-pocket portion of $380 may not be low for some. Urban and rural residents need to pay part of the medical insurance benefits themselves, regardless of whether they are 30 years old or 80 years old, they must be treated equally.

Different cities have slightly different requirements for payment, such as Shanghai, where they have a policy preference for the elderly over 60 years old.

As you get older, the amount of the out-of-pocket contribution decreases. Seniors between the ages of 60 and 69 pay 715 yuan a year in Shanghai, while those over 70 years old pay 545 yuan, which is a certain discount.

Very important reminder!The medical insurance payment is to enjoy the medical insurance treatment in 2024. The deadline is the end of this year, so it is important for you to complete the payment within this time to ensure that you can enjoy medical insurance. If you miss the payment deadline, you will not be able to get health insurance benefits in 2024. Therefore, please be sure to pay the fee in time and do not delay important things.

The second good news is that it can also benefit many people, and the coverage of medical insurance reimbursement has been expanded. This time, in terms of medical insurance payment management, five specific requirements were clearly put forward: 1. Strengthening the management of the drug catalogue and the centralized procurement of medicines: The medical insurance department proposed to further strengthen the management of the drug catalogue guaranteed by the medical insurance, and continue to promote the centralized procurement of medicines.

Since a few years ago, centralized drug procurement has been carried out nationwide as a key part of the medical reform. Through the centralized procurement of drugs, the ** of many drugs has been reduced, most of which are more than 80%, and even the ** of some drugs has decreased by more than 90%.

In particular, the price reductions of some commonly used drugs have greatly reduced the cost of purchasing drugs and seeing a doctor for the common people, and at the same time have also reduced the corruption and kickbacks in the process of pharmaceutical circulation. 2. Expand the scope of medical insurance payment: The medical insurance department requires more eligible medical consumables and services to be included in the scope of medical insurance payment.

In recent years, the medical insurance department has made great efforts in this regard. Many of the previously most expensive medical consumables have been covered by medical insurance, such as cardiac bypass surgery consumables and dental medical consumables.

This is especially important for people with dental problems, especially older ones. In the past, dental implants could cost tens of thousands of yuan, but now dental implants can also be reimbursed within the scope of medical insurance, saving people a lot of costs.

It is worth mentioning that this document also emphasizes the reimbursement of reproductive medical care, which is an important policy change, especially in the context of insufficient population growth, which is of great significance. These measures will help to further improve the level of medical insurance protection, reduce medical costs, and reduce people's burden.

3. Establish a scientific and strict evaluation system: formulate scientific evaluation standards, evaluate the efficacy and safety of traditional Chinese medicine and ethnic medicine, and ensure that drugs and methods that meet the requirements are included in the scope of medical insurance. Crack down on illegal acts of Chinese herbal medicines: strengthen the supervision of the Chinese herbal medicine market, crack down on illegal acts such as theft and speculation of Chinese herbal medicines, and maintain the order and good image of traditional Chinese medicine and ethnic medicine.

Improve the verification mechanism for medical insurance access: strengthen the verification of the eligibility for participation in traditional Chinese medicine and ethnic medicine, improve the insurance account, and ensure full coverage of insurance, payment and insurance.

Fourth, for the proportion of medical insurance payment, 70% can be said to be a basic starting point. This means that the proportion of hospitalization expenses that can be covered by medical insurance should be maintained at about 70% of the hospitalization costs for diseases that meet the policy.

Such a ratio can play a certain role in guaranteeing and reducing the financial burden of patients. However, the economic situation and medical needs of different regions and groups of people vary, so it is necessary to consider a variety of factors when considering whether the payment ratio is adequate.

In some special cases, patients may have to pay a higher percentage of the cost, so there may be quite a few people who expect to pay a higher percentage. In addition, the proportion of health insurance payments is also related to the sustainability of the health insurance system.

5. On the premise of ensuring the balance and stability of medical insurance**, appropriately increasing the payment ratio may require more comprehensive system design and funding arrangements. To sum up, the current 70% overall payment ratio can be used as a basic starting point, but whether it is sufficient needs to be evaluated and adjusted according to the actual situation.

For some special diseases and high medical expenses, it is possible to consider increasing the payment ratio or providing special medical insurance policies and relief measures to reduce the burden on patients and families. In addition, with the development of medical technology and the continuous improvement of medical services, medical expenses are also increasing.

Therefore, the proportion of medical insurance payment needs to be commensurate with it to ensure that the people can access affordable medical care. In short, the determination of the payment ratio needs to take into account a variety of factors, including economic status, medical needs, and the sustainability of health insurance**. When formulating and adjusting policies, it is necessary to solicit opinions from all parties and balance the interests of all parties to achieve the fairness, sustainability and operability of the medical insurance system.

Through Internet technology, the payment and reimbursement of online medical services can be realized, and the convenience and efficiency of medical treatment can be improved.

At the same time, through the linkage of medical insurance between different regions, mutual recognition of medical insurance and the convenience of cross-regional medical treatment can be realized. Simplifying the process of medical insurance payment and improving the convenience of medical services are the trends of medical insurance development in the future. This will reduce people's expenses and the number of errands, and improve the efficiency and practicality of medical security.

The last piece of good news is about strengthening the support of medical insurance for rural revitalization. Specifically, it includes optimizing the insurance policy, increasing the enthusiasm of farmers to participate in insurance, promoting a long-term mechanism to solve poverty caused by illness, and expanding the relief work for sick and difficult rural families.

The implementation of these policies will help improve the level of health protection for farmers and prevent poverty due to illness, which is undoubtedly good news for most policyholders. While paying for health insurance can be a burden, purchasing basic insurance is an important way to ensure that your family doesn't face significant financial risk due to an accident or illness.

Farmers and people in rural areas often face a higher risk of disease and economic hardship, so it is particularly important for them to strengthen the support of medical insurance for rural revitalization. Optimizing the policy of categorical subsidy and improving the insurance verification mechanism and insurance account can ensure full coverage, full payment and insurance coverage of the rural poor.

This will provide farmers with more comprehensive health care and reduce their risk of falling ill into poverty. Second, to promote a long-term mechanism to prevent and solve poverty caused by illness, rural households can prevent rural families from falling into poverty again due to illness by setting assistance thresholds and monitoring with big data. This helps to improve the health and quality of life of farmers.

Finally, to expand the relief work for rural families suffering from diseases and difficulties, in addition to the support of ** and policies, it also requires the active participation of social forces. Establish various relief systems to provide more support and assistance to farmers in need. In summary, strengthening the support of medical insurance for rural revitalization is good news, especially for farmers and people in rural areas. Through these measures, it is hoped that their health care will be improved, the risk of poverty due to illness will be reduced, and the development and revitalization of rural areas will be promoted.

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