The sustained and rapid development of the economy and society has brought about the prosperity of various undertakings of the country and society. However, at the same time, development has also brought some other problems, such as the destruction of the environment to varying degrees, the rapid acceleration of the aging process of the population, the emergence of the situation of growing old before getting rich, and the proportion of the elderly gradually increasing. Young people's poor living and eating habits, alcoholism, staying up late, obesity, not liking exercise, etc., the probability of the elderly suffering from various chronic diseases is very high, and many chronic diseases have a tendency to be younger.
Many chronic diseases cannot be controlled, and the development of the disease can only be controlled through long-term treatment or medication to achieve the purpose of improving the quality of life and survival life. For patients and their families, the burden of chronic disease patients is both physical and mental, and high medical costs are required. Now is the era of universal insurance, and when the medical expenses are high, it is hoped that the reimbursement of basic medical insurance can reduce the financial burden of the insured.
When the medical insurance system was first established, the insured people basically sought medical treatment in small clinics for common diseases, chronic diseases and other diseases, and the frequency of outpatient medical treatment in hospitals was not high, and the medical expenses were not large. Therefore, the overall reimbursement is mainly based on hospitalization, and the cost of outpatient and pharmacy drug purchases is generally paid with the medical insurance personal account. Later, the incidence of chronic diseases was sharp, medical technology advanced rapidly, medical equipment was very advanced, outpatient medical expenses and frequency of medical treatment also increased a lot, and the related expenses of chronic diseases were also included in the reimbursement scope of basic medical insurance.
Due to the different economic development of different places, the population and age structure are also different, so in terms of reimbursement for chronic diseases, there will still be some differences in different places, and the scope and number of diseases will be different. In economically developed places, the amount of medical insurance financing will be higher, and the population inflow will be larger, young people will account for a relatively large proportion, and the expenditure will be relatively small, so the number of diseases will be more, and the scope of reimbursement will be larger. Fang Ran, some common chronic diseases will basically be included, the prevalence rate is high, the cost is large, and the inclusion of medical insurance reimbursement can reduce the burden of medical treatment for the insured people.
Since this year, there are some common chronic diseases that have been included in the reimbursement scope of medical insurance in many places, of which these 37 are relatively common chronic diseases, which have been included in the reimbursement scope in various places.
These include: multidrug-resistant tuberculosis, severe psychosis, hypertension with complications, diabetes with complications, epilepsy, stroke, myasthenia gravis, Crohn's disease, ankylosing spondylitis, severe osteoporosis, Alzheimer's disease, rheumatoid arthritis, glaucoma, chronic osteomyelitis, hyperthyroidism, thrombocytopenic purpura, psoriasis, gout, AIDS, necrosis of the femoral head, hypercortisolism, schistosomiasis, osteoarthritis.
Heart: coronary heart disease, chronic heart failure, cardiomyopathy.
Liver: chronic hepatitis, cirrhosis.
Lungs: chronic bronchitis, chronic obstructive pulmonary disease, bronchial asthma.
Kidneys: chronic kidney disease, urinary stones, primary chronic adrenal insufficiency.
There are more than 30 kinds of chronic diseases, including various chronic diseases of important organs such as the heart, liver, and kidneys, as well as high blood pressure and diabetes.
The reimbursement ratio of these chronic diseases is the same as hospitalization, and the higher the level of the medical institution, the lower the reimbursement ratio of medical insurance, so it is best to go to the grassroots medical institutions for medical treatment when looking at these chronic diseases, which can save a lot of money. Taking Jiangxi's resident medical insurance as an example, if you seek medical treatment in a first-class medical institution, the reimbursement ratio is as high as 90%, while if you seek medical treatment in a first-class medical institution, the reimbursement ratio is only 60%, which is a great reduction.
Chronic diseases are different from hospitalization reimbursement in that chronic disease medical insurance reimbursement does not set a minimum payment line, but will set a cap line and reimbursement scope, so there are a variety of chronic diseases that require each application, which can be reimbursed a lot, reduce some burdens, and save money.