The reporter learned from the National Health Insurance Administration that on March 2, the National Health Insurance Bureau, the Ministry of Education, the National Health Commission and other five departments issued a notice to carry out a special action for children to participate in basic medical insurance.
By the end of 2024, more than 80% of newborns will be insured in the year of birth
Focusing on achieving the annual insurance participation target of more than 95% proposed in the "14th Five-Year Plan" for universal medical security, the "Notice" clearly states that by the end of 2024, more than 80% of newborns will be insured in the year of birth. By the end of the 14th Five-Year Plan period, the participation rate of children in the insurance rate has increased steadily. On the premise of maintaining the relative stability of the children's insurance policy, the focus is on optimizing the insurance participation process for newborn children, simplifying the registration process, improving services, putting forward targeted work requirements, and encouraging local exploration and innovation to improve the level of children's insurance coverage, protect children's rights and interests, and safeguard children's health.
The number of insured children in 2023 is 25.6 billion people
Children are the hope of the family and the future of the country and the nation, and children's participation in basic medical insurance in accordance with the law is of great significance to ensure the healthy growth of children, and is also an important guarantee for the happy life of tens of millions of families. Since the establishment of the medical insurance system for urban and rural residents in China, the number of children insured has increased steadily, and the number of insured children in 2023 will be 25.6 billion peopleThe steady growth of the number of children insured has played a fundamental and fundamental role in protecting children's health rights. However, at the same time, there are also problems such as many procedures and long processes for newborns to participate in insurance, a small number of parents do not have a strong sense of participation in insurance, and the restrictions on household registration of permanent residents in individual cities have not been fully relaxed. In order to safeguard children's rights and interests in medical security, the National Health Insurance Administration, together with the Ministry of Education, the National Health Commission, the Working Committee on Women and Children, and the All-China Women's Federation, has researched and drafted the Notice on Carrying out Special Actions for Children to Participate in Basic Medical Insurance.
Intensify the mobilization of children to participate in insurance
Departments and units at all levels such as medical insurance, education, public health, and women's federations should earnestly increase the intensity of publicity and mobilization for insurance participation. Local medical insurance departments should mobilize childcare establishments, communities with childcare service functions, and employers that provide welfare childcare services for employees, etc., to strengthen publicity on children's parents and other guardians' participation in insurance, and promote and guide children to participate in basic medical insurance. Medical insurance agencies at all levels should take the initiative to understand the insurance situation of newborns when handling the reimbursement of maternity medical expenses, and timely publicize and mobilize the insurance participation. The medical insurance department should take the initiative to go deep into the community, etc., and focus on carrying out child-friendly policy publicity, so as to enhance parents' awareness of their children's timely participation in basic medical insurance. The offices of the working committees on women and children at all levels should play the functions of organizing, coordinating, guiding, and supervising, and make consolidating and increasing the coverage rate of children's participation in basic medical insurance for urban and rural residents one of the key goals and tasks of implementing the "China Children's Development Program (2021-2030)".
Optimize the newborn enrollment process
All localities should accelerate the implementation of the integrated handling of "one thing at birth", and for areas that have not yet been implemented, medical insurance, health and other departments should strengthen information sharing, and do a good job of newborn insurance in a timely manner. In principle, newborns should participate in insurance and pay premiums within 90 days after birth, and all medical expenses incurred from the date of birth can be included in the scope of medical insurance reimbursement. If the individual co-ordination area does not conform to the above provisions, it shall be adjusted in accordance with the above provisions as soon as possible. Encourage localities to explore the use of birth medical certificates to handle newborn insurance, and can apply for medical insurance codes for them through family accounts or handling agencies, and within 180 days after birth, they can use the medical insurance code to directly seek medical treatment and settlement in designated medical institutions. The medical insurance department instructs the parents of newborns to update the newborn's insurance information in a timely manner after they settle down for their newborns.
Do a good job of subsidizing and participating in medical assistance for all types of children in difficulty who meet the requirements for funding
On the basis of consolidating the level of hospitalization treatment, the level of outpatient protection of residents' medical insurance, including children, can be steadily improved according to the level of economic and social development and the affordability of medical insurance. Do a good job of subsidizing and participating in medical assistance for all types of children in difficulty who meet the requirements for funding, and ensure that they participate in insurance in a timely manner. All localities should further implement the policy of holding residence permits to participate in insurance, create conditions to relax restrictions on children's household registration, and promote the participation of children with household registration in other places of permanent residence and school registration. It is necessary to study and improve the incentive and restraint measures for insurance payment, give full play to the role of family doctors, and include family doctors in the contracted service package to carry out insurance mobilization services. Support insured employees to use their personal accounts for employee medical insurance for their children's personal contributions to participate in resident medical insurance. Support the development of pediatric medical services, protect children's health rights, and effectively improve the level of medical services.
Strengthen data sharing between departments
Departments such as for medical insurance, education, and health at all levels should coordinate and cooperate and take the initiative to strengthen data sharing, promptly and accurately grasp the participation of all types of children, and ensure that all types of children are fully insured. It is necessary to continuously optimize the insurance process, and the medical insurance department at the same level should do a good job of registration in the medical insurance information system at one time, so as to reduce the number of errands for parents and other guardians of children; The medical insurance departments for children's permanent residence, place of school registration, and place of household registration should coordinate and cooperate, work together, break down data barriers, strengthen information sharing, and promptly analyze the reasons why primary and secondary school students are not insured, and help coordinate and resolve them. Local medical insurance departments should take the initiative to obtain information on children such as immunization vaccination sites and village clinics, and promptly grasp the basic situation of the children targeted for expansion.
In the next step, the National Health Insurance Administration, together with the Ministry of Education, the Health Commission, the Working Committee on Women and Children, the Women's Federation and other departments, will guide and urge relevant departments in accordance with the requirements of the "Notice" to carry out special actions for children to participate in basic medical insurance, effectively improve the level of children's insurance coverage, protect children's rights and interests, and safeguard children's health.
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