On March 2, the National Health Insurance Administration interpreted the relevant policies on the "Notice on Carrying out Special Actions for Children to Participate in Basic Medical Insurance", aiming to optimize the process of children's medical insurance participation and improve the participation rate of children.
Cai Fucheng, deputy chief physician of the Department of Pediatrics of Wuhan Jinyinhu Hospital, told the reporter of the people's health client that there are still some challenges in the process of neonatal medical insurance, and the phenomenon of "window period" needs to be solved urgently.
The insurance participation rate has increased steadily, and parents' awareness of active insurance still needs to be strengthened.
Taking Wuhan *** as an example, Cai Fucheng clearly feels that the insurance rate of newborns is increasing year by year. "The hospital has increased the publicity of medical insurance policies at key stages such as pregnant women's health care, before and after childbirth, and professional medical staff have popularized children's medical insurance knowledge to expectant mothers. At present, the insurance rate of newborns in hospitals is close to more than 95%. ”
Cai Fucheng, deputy chief physician of the Department of Pediatrics of Wuhan *** Jinyinhu Hospital, received the patient. Photo courtesy of the interviewee.
Cai Fucheng introduced that for those babies who were admitted to the neonatal intensive care unit at birth, parents have a particularly strong sense of insurance. "Under the policy that the newborn can still use the medical insurance to reimburse the relevant medical expenses within three months after discharge, parents will take the initiative to understand and go through the medical insurance procedures. ”
However, for families with newborns who were born successfully and had no obvious health problems, their awareness of insurance participation was relatively passive. "Some parents of healthy newborns don't realize that their children can also be enrolled in insurance immediately, and they don't even know that children's medical insurance can effectively reduce the financial burden of families due to common infant diseases. ”
Cai Fucheng emphasized that the "Notice" set the goal of achieving more than 80% of newborns participating in insurance in the year of birth by the end of 2024, and simplifying the insurance process for newborn children, which is of far-reaching significance for reducing the financial burden of parents and ensuring that newborns enjoy medical insurance rights and interests in a timely manner. She reminded that even if the newborn baby has no obvious health problems, infants and young children aged 0-1 years, especially those under the age of 5, are at higher risk of disease due to incomplete immune system development.
Optimize the reminder mechanism to fill the "window period" for renewal
In response to the problems in the process of renewing children's medical insurance, Cai Fucheng proposed that the phenomenon of "window period" needs to be solved urgently, especially from kindergarten to primary school, and some parents are prone to neglect their children's medical insurance renewal. "At present, in the transition stage from kindergarten to primary school, the lack of an effective renewal reminder mechanism is a common problem. However, after entering primary school, the education department usually reminds parents to pay medical insurance fees at the beginning of the school year, so as to effectively avoid omissions. ”
Cai Fucheng believes that the current neonatal medical insurance policy has achieved good results, but how to strengthen publicity and improve the reminder mechanism, so that parents can fully understand the importance of children's medical insurance, and effectively solve the problem of "window period" in the process of medical insurance renewal will be the key to improving the participation rate of children's medical insurance in the future.